Nutrivida LLC

Primary specialty

Oncology Nutrition Registered DietitianTaxonomy code 133VN1301X

Legal business name

NUTRIVIDA LLC

Practice address

53 Calle Dr Goyco
Caguas, PR 00725-2624

Phone

(787) 652-7601

NPI assigned

Feb 20, 2022

Organization subpart

No

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

Authorized official

Name

Joselyn M Perez, RDNNPI 1467691972

Title

Officer

Phone

(939) 652-7601

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joselyn M Perez, LND

  • Nutrition Education Nutritionist
  • Gurabo, PR
  • NPI 1467691972
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1645315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712448000000",
    "number": "1225783012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 CALLE URANO LOS PAISAJES CIUDAD JARDIN",
            "city": "GURABO",
            "state": "PR",
            "postal_code": "007789211",
            "telephone_number": "939-652-7601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 CALLE DR GOYCO",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007252624",
            "telephone_number": "787-652-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRIVIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-20",
        "last_updated": "2024-04-07",
        "certification_date": "2024-04-07",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "JOSELYN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "939-652-7601",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133VN1301X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIETITIAN",
            "identifier": "1467691972",
            "state": "PR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467691972",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Caguas, PR
• Providers in Caguas, PR by specialty
• Registered Dietitian in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2024; 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.