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General NPI Number Information
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NPI Number | 1194617167
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Entity Type | Individual
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Provider Name | JAVIER E MORENO ECHEVARRIA
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Gender | Male
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Dates
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Enumeration Date | 07/16/2025
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | CARR 11 KM 1.9 AVENIDA LOS PATRIOTAS
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City | LARES
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State | PR
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Zip | 00669-0379
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Country | US
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Telephone | 787-897-2727
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Fax | 787-897-2725
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Provider Business Mailing Address
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Address Line | PO BOX 4830
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City | AGUADILLA
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State | PR
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Zip | 00605-4830
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Country | US
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Telephone | 787-378-3625
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 002297
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License Number State | PR
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