MEDICARE: CARLOS ANTONIO SANTALIZ RIVERA RDN, 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	133V00000X	Registered Dietitian	86415226	PR

General Provider Information

NPI Number	:	1952244634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS ANTONIO SANTALIZ RIVERA RDN, LND

Provider Business Mailing Address
First Line	:	494 SECTOR JUSTO RODRIGUEZ, BO. ARENAS
Second Line	:
City	:	CIDRA
State	:	PR
Zip	:	00739
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	494 SECTOR JUSTO RODRIGUEZ, BO. ARENAS
Second Line	:
City	:	CIDRA
State	:	PR
Zip	:	00739
Country	:	US
Telephone Number	:	787-586-0361
Fax Number	:

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

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	04/09/2026

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