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General NPI Number Information
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NPI Number | 1679726178
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Entity Type | Individual
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Provider Name | GERALDINE GUAL LND
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Gender | Female
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Dates
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Enumeration Date | 10/28/2008
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Last Update Date | 10/28/2008
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Provider Practice Location Address
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Address Line | 204-8 CALLE 435 VILLA CAROLINA
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City | CAROLINA
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State | PR
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Zip | 00985-3019
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Country | US
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Telephone | 787-977-2145
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Fax | 787-977-2134
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Provider Business Mailing Address
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Address Line | 204-8 CALLE 435 VILLA CAROLINA
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City | CAROLINA
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State | PR
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Zip | 00985-3019
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Country | US
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Telephone | 787-977-2145
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Fax | 787-977-2134
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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 | 1412
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License Number State | PR
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