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General NPI Number Information
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NPI Number | 1427541606
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Entity Type | Organization
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Legal Business Name | LCDA.MORAIMA GARCIA VERGARA
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Dates
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Enumeration Date | 06/12/2018
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Last Update Date | 05/27/2022
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Provider Practice Location Address
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Address Line | 50 CALLE VICTORIA STE 17 LEGACY MEDICAL CENTER
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City | HUMACAO
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State | PR
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Zip | 00791-3337
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Country | US
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Telephone | 787-318-2041
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Fax |
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Provider Business Mailing Address
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Address Line | 104 CALLE LUIS MUNOZ RIVERA
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City | YABUCOA
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State | PR
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Zip | 00767-3103
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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 | NUTRITIONIST/DIETITIAN
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Name | MORAIMA GARCIA
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Credential |
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Telephone | 787-318-2041
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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