Maribel Collazo
Individual provider Active NPI Nutritionist · Hato Rey, PR
NPI 1477673283 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1477673283
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nutritionist 133N00000X
- License
- 1298 (PR)
- Practice address
- Calle Sergio Cuevas Bustamante 550
Hato Rey, PR 00918 - Phone
- (787) 758-8383
- NPI assigned
- Mar 29, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1298 | PR | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | 1298 | PR | Yes |
Addresses
Primary practice location
Calle Sergio Cuevas Bustamante 550
Hato Rey, PR 00918
Mailing address
473 Calle Bayamon
La Cumbre
San Juan, PR 00926-5558
Phone (787) 922-7053
Other providers in Hato Rey, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.