Clinica de Nutricion del Sur LLC

Primary specialty

Nutrition Education NutritionistTaxonomy code 133NN1002X

Legal business name

CLINICA DE NUTRICION DEL SUR LLC

Practice address

Calle Segundo Bernier
Coamo, PR 00769

Phone

(787) 803-8221

NPI assigned

Dec 22, 2023

Last updated

Dec 28, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Edwill Burgos

Title

Lic

Phone

(787) 242-6225

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edwill Burgos-Velazquez, LCDO

  • Nutrition Education Nutritionist
  • Coamo, PR
  • NPI 1679963722

  Nutrition, Education

  Medicare reassignment NPD
• Maria Teresa Rios Vazquez, LND

  • Nutritionist
  • Ponce, PR
  • NPI 1962871731
  NPD (past)

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

{
    "created_epoch": "1703203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703721600000",
    "number": "1306615091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 83",
            "city": "SANTA ISABEL",
            "state": "PR",
            "postal_code": "007570083",
            "telephone_number": "787-226-1176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE SEGUNDO BERNIER",
            "city": "COAMO",
            "state": "PR",
            "postal_code": "00769",
            "telephone_number": "787-803-8221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA DE NUTRICION DEL SUR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-22",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A",
        "authorized_official_last_name": "BURGOS",
        "authorized_official_first_name": "EDWILL",
        "authorized_official_title_or_position": "LIC",
        "authorized_official_telephone_number": "787-242-6225"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinica Pap Policlinica
• Clinica Quiropractica Correctiva Santa Isabel
• Clinica Terapeutica Atletica Loavi
• Coamo Health Institute

• Nutrition Education Nutritionist in Coamo, PR
• Providers in Coamo, 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 Dec 28, 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.