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General NPI Number Information
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NPI Number | 1376989798
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Entity Type | Individual
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Provider Name | MYRNA BERRIOS NUTRITIONIST
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Gender | Female
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Dates
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Enumeration Date | 05/13/2013
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Last Update Date | 05/13/2013
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Provider Practice Location Address
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Address Line | B5 CALLE TABONUCO STE 211 GALERIA SAN PATRICIO
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City | GUAYNABO
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State | PR
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Zip | 00968-3013
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Country | US
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Telephone | 787-522-0540
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Fax | 787-522-0541
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Provider Business Mailing Address
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Address Line | B5 TABONUCO STREET GALERIA SAN PATRICIO SUITE 211
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City | GUAYNABO
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State | PR
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Zip | 00968
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Country | US
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Telephone | 787-522-0540
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Fax | 787-522-0541
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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 | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | 629
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License Number State | PR
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