Individual provider Active NPI

Crystalee Santiago Aviles, LND

  • Nutritionist
  • Vega Baja, PR
National Provider Identifier
1477150357
Registry record updated Oct 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
1676 Issued in PR
Practice address
Urbanizacion San Demetrio Calle Casabe
Apartamento 102
Vega Baja, PR 00694
Phone
(787) 516-6525
NPI assigned
Oct 5, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 1676 PR Primary

Addresses

Primary practice location

Urbanizacion San Demetrio Calle Casabe
Apartamento 102
Vega Baja, PR 00694

Mailing address

HC 1 Box 5709
Barranquitas, PR 00794-9420
Phone (787) 516-6525

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1676PRMDNutritionist

NPI Registry JSON

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1477150357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 1 BOX 5709",
            "city": "BARRANQUITAS",
            "state": "PR",
            "postal_code": "007949420",
            "telephone_number": "787-516-6525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URBANIZACION SAN DEMETRIO CALLE CASABE",
            "address_2": "APARTAMENTO 102",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "00694",
            "telephone_number": "787-516-6525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO AVILES",
        "first_name": "CRYSTALEE",
        "name_prefix": "Miss",
        "credential": "LND",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-05",
        "last_updated": "2020-10-05",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "PR",
            "license": "1676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vega Baja, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; 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.