Individual provider Active NPI

Eunice Gonzalez Guang, LCDA.

  • Registered Dietitian
  • San Juan, PR
National Provider Identifier
1629736780
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
001291 Issued in PR
Practice address
1492 Ponce de Leon Ave
Edificio Centro Europa 717
San Juan, PR 00907
Phone
(787) 723-5017
Fax
(787) 723-5015
NPI assigned
Dec 6, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 001291 PR Primary

Addresses

Primary practice location

1492 Ponce de Leon Ave
Edificio Centro Europa 717
San Juan, PR 00907

Mailing address

PO Box 11577
Fernandez Juncos Station
San Juan, PR 00910
Phone (787) 723-5017

Other identifiers 1

IdentifierTypeStateIssuer
001291OtherPRLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220201002515 PR Practitioner - Registered Dietitian Or Nutrition Professional 8729471446 Practice locations: San Juan, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001291PRMDRegistered Dietitian
1291PRMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiomed LLC CurrentSince Dec 12, 2021 Accepting new patients
Cardiovascular Healthcare LLC CurrentSince Dec 12, 2021 Accepting new patients

Locations

1492 Ave Ponce de Leon
Ste 717
Santurce, PR 00907
Phone (787) 462-0646

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1638748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1629736780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11577",
            "address_2": "FERNANDEZ JUNCOS STATION",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00910",
            "telephone_number": "787-723-5017",
            "fax_number": "787-723-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1492 PONCE DE LEON AVE",
            "address_2": "EDIFICIO CENTRO EUROPA 717",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00907",
            "telephone_number": "787-723-5017",
            "fax_number": "787-723-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ GUANG",
        "first_name": "EUNICE",
        "credential": "LCDA.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-06",
        "last_updated": "2021-12-06",
        "certification_date": "2021-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PR",
            "license": "001291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "001291",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; 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.