MEDICARE: KIARA MARIE TORRES CASTRO RD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	2175	PR

General Provider Information

NPI Number	:	1104592195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIARA MARIE TORRES CASTRO RD

Provider Business Mailing Address
First Line	:	URB LAS LOMAS
Second Line	:	783 CALLE 33 SO
City	:	SAN JUAN
State	:	PR
Zip	:	00921
Country	:	US
Telephone Number	:	939-452-0718
Fax Number	:

Provider Business Practice Location Address
First Line	:	232 CALLE ELEONOR ROOSEVELT
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00918-3048
Country	:	US
Telephone Number	:	939-452-0718
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2021
Last Update Date	:	01/15/2025

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