MEDICARE: MISS VALERIA MARIA SANTA ROMAN LND

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	171400000X	Health & Wellness Coach		PR
2	133NN1002X	Nutrition Education Nutritionist	2187	PR
3	374J00000X	Doula		PR
4	133N00000X	Nutritionist	2187	PR
5	133V00000X	Registered Dietitian	2187	PR

General Provider Information

NPI Number	:	1174280051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS VALERIA MARIA SANTA ROMAN LND

Provider Business Mailing Address
First Line	:	PMB 291 POBOX 4960
Second Line	:
City	:	CAGUAS
State	:	PR
Zip	:	00726
Country	:	US
Telephone Number	:	787-379-2965
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 AVE RAFAEL CORDERO
Second Line	:	PLAZA DEL MERCADO, SEGUNDO NIVEL, OFICINA #9
City	:	CAGUAS
State	:	PR
Zip	:	00725-3811
Country	:	US
Telephone Number	:	787-379-2965
Fax Number	:

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

Provider Enumeration Date	:	11/26/2021
Last Update Date	:	03/06/2026

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