Wanda Lopez Santiago, LND, CLE
Individual provider Active NPI Nutritionist · Comerio, PR
NPI 1013137306 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1013137306
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nutritionist 133N00000X
- License
- 1023 (PR)
- Practice address
- HC 2 Box 7068
Comerio, PR 00782-9611 - Phone
- (787) 516-2409
- NPI assigned
- Apr 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1023 | PR | MD | Audiologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | 1023 | PR | Yes |
Addresses
Primary practice location
HC 2 Box 7068
Comerio, PR 00782-9611
Mailing address
HC 02 Box 7068
Comerio, PR 00782
Other providers in Comerio, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.