MEDICARE: ISNAELY RIVERA O'FARRILL 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	133VN1004X	Pediatric Nutrition Registered Dietitian	1698	PR

General Provider Information

NPI Number	:	1770438160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISNAELY RIVERA O'FARRILL LND

Provider Business Mailing Address
First Line	:	PO BOX 904
Second Line	:
City	:	TRUJILLO ALTO
State	:	PR
Zip	:	00977-0904
Country	:	US
Telephone Number	:	787-235-1358
Fax Number	:

Provider Business Practice Location Address
First Line	:	2-6 MUNOZ RIVERA FERRER ST
Second Line	:
City	:	GUAYNABO
State	:	PR
Zip	:	00969-5706
Country	:	US
Telephone Number	:	787-402-7304
Fax Number	:

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

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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