Alicia Z Diaz Boulon, LND, RD, MHSN, CDE

Primary specialty

Nutrition Education NutritionistTaxonomy code 133NN1002X

License

1239 Issued in PR

Practice address

La Alameda
785 Calle Rubi
San Juan, PR 00926-6733

Phone

(787) 422-0202

NPI assigned

Jun 5, 2007

Last updated

Oct 9, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349740800000",
    "number": "1235331745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LA ALAMEDA",
            "address_2": "785 CALLE RUBI",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009266733",
            "telephone_number": "787-422-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LA ALAMEDA",
            "address_2": "785 CALLE RUBI",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009266733",
            "telephone_number": "787-422-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ BOULON",
        "first_name": "ALICIA",
        "middle_name": "Z",
        "credential": "LND, RD, MHSN, CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-05",
        "last_updated": "2012-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "PR",
            "license": "1239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RD",
            "identifier": "867067",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LND",
            "identifier": "1239",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERT.  DIABETES EDUCATOR",
            "identifier": "2062-0127",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ada I Diaz Rodriguez, MD
• Elizandra Diaz Agosto, RPT
• Nicole Shairy Diaz Alicea, RN
• Heidy Diaz Aragon
• Elsie Angelic Diaz Baez
• Yaretzie Marie Diaz Catala
• Alexis Diaz Cintron, M.D.
• Ashlie Diaz Colon, DMD, MPH
• Maria Margarita Diaz Fernandez, M.D.
• Ashley Marie Diaz Figueroa, MD

• Nutrition Education Nutritionist in San Juan, PR
• Providers in San Juan, PR by specialty
• Nutrition Education Nutritionist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; 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.