Individual provider Active NPI

Mariela Pizarro, LND

  • Nutritionist
  • Dorado, PR
National Provider Identifier
1104374941
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
1761 Issued in PR
Practice address
746 Calle Mar de Bengal
Paseo Los Corales II
Dorado, PR 00646
Phone
(787) 604-1235
NPI assigned
Sep 21, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 1761 PR Primary

Addresses

Primary practice location

746 Calle Mar de Bengal
Paseo Los Corales II
Dorado, PR 00646

Mailing address

1299 Calle W Bosch Apt 610
San Juan, PR 00924-4667

Other identifiers 1

IdentifierTypeStateIssuer
1761OtherPRCNDPR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1474416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1104374941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1299 CALLE W BOSCH APT 610",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009244667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "746 CALLE MAR DE BENGAL",
            "address_2": "PASEO LOS CORALES II",
            "city": "DORADO",
            "state": "PR",
            "postal_code": "00646",
            "telephone_number": "787-604-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIZARRO",
        "first_name": "MARIELA",
        "credential": "LND",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-21",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "PR",
            "license": "1761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CNDPR",
            "identifier": "1761",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorado, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.