Individual provider Active NPI

Jennifer Suarez Serrano, LND

  • Nutritionist
  • Caguas, PR
National Provider Identifier
1043646227
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
1840 Issued in PR
Practice address
Avenida Luis Munoz Marin
R-9 Mariolga
Caguas, PR 00725
Phone
(787) 961-5656
NPI assigned
Sep 19, 2013
Last updated
Jul 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 1840 PR Primary

Addresses

Primary practice location

Avenida Luis Munoz Marin
R-9 Mariolga
Caguas, PR 00725

Mailing address

Urbanizacion Palacios del Sol #7
Humacao, PR 00791
Phone (787) 475-4933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170605002685 PR Practitioner - Registered Dietitian Or Nutrition Professional 0042587537 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1840PRMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Tu Clinica de Nutricion Y Bienestar Corp. Nutritionist CurrentSince Feb 13, 2017 Accepting new patients

Locations

R9 Ave Luis Munoz Marin
Caguas, PR 00725
Phone (787) 961-5656

1 Calle Eulalio Reveron
Yabucoa, PR 00767
Phone (787) 457-4933

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1043646227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URBANIZACION PALACIOS DEL SOL #7",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "00791",
            "telephone_number": "787-475-4933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVENIDA LUIS MUNOZ MARIN",
            "address_2": "R-9 MARIOLGA",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00725",
            "telephone_number": "787-961-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUAREZ SERRANO",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "LND",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-19",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "PR",
            "license": "1840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caguas, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.