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General NPI Number Information
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NPI Number | 1265242937
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Entity Type | Organization
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Legal Business Name | INTERNACIONAL CLUSTER BUSINESS & ASOCIADOS INCLA LLC
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Dates
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Enumeration Date | 01/13/2025
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | ARZOBISPO PORTES NUM 856 SUITE 106
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City | SANTO DOMINGO
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State | DISTRITO NACIONAL
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Zip | 10208
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Country | DO
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Telephone | 809-960-2897
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Fax |
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Provider Business Mailing Address
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Address Line | 8298 NW 21ST ST APT X50430
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City | DORAL
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State | FL
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Zip | 33122-0002
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | YANGEL DANIEL NUNEZ SANTANA
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Credential |
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Telephone | 809-960-2897
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1201X
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Taxonomy Name | Obesity and Weight Management Nutrition Registered Dietitian
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License Number |
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License Number State |
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