Individual provider Active NPI

Luz Aidyl Marie Perez Rodriguez, LND

  • Nutrition Education Nutritionist
  • San Juan, PR
National Provider Identifier
1679190417
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition Education NutritionistTaxonomy code 133NN1002X
License
2120 Issued in PR
Practice address
60 Calle Bolivia
San Juan, PR 00917-2120
Phone
(787) 230-7530
NPI assigned
Jun 27, 2020
Last updated
Jun 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education Nutritionist 133NN1002X 2120 PR Primary

Addresses

Primary practice location

60 Calle Bolivia
San Juan, PR 00917-2120

Mailing address

PO Box 9976
Arecibo, PR 00613-9976
Phone (787) 230-7530

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230921003683 PR Practitioner - Registered Dietitian Or Nutrition Professional 6002279692 Reassigns benefits to 1 organization
Practice locations: San Juan, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2120PRMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Why Nutrition LLC Nutritionist CurrentSince May 16, 2024 Accepting new patients
Metro Healthcare Management System CurrentSince Oct 24, 2021 Accepting new patients

Locations

60 Calle Bolivia
San Juan, PR 00917
Phone (787) 685-8633

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1593216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1679190417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9976",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006139976",
            "telephone_number": "787-230-7530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 CALLE BOLIVIA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009172120",
            "telephone_number": "787-230-7530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ RODRIGUEZ",
        "first_name": "LUZ",
        "middle_name": "AIDYL MARIE",
        "credential": "LND",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-27",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "PR",
            "license": "2120",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 30, 2020; 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.