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NPI Code Detail

MEDICARE: MARIDELY CORDERO LND

MEDICARE: MARIDELY CORDERO 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
1133N00000XNutritionist1596PR

General Provider Information

NPI Number : 1720467616
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIDELY CORDERO LND
Provider Business Mailing Address
First Line : HC 7 BOX 76350
Second Line :
City : SAN SEBASTIAN
State : PR
Zip : 00685-7366
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 66 CALLE MJ CABRERO
Second Line :
City : SAN SEBASTIAN
State : PR
Zip : 00685-4843
Country : US
Telephone Number : 787-452-2200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2015
Last Update Date : 07/13/2024

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