Active NPI
Elba Elisa Gonzalez, LD,RD,MBA,CPT
- Pediatric Nutrition Registered Dietitian
- Trujillo Alto, PR
National Provider Identifier
1992851778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nutrition Registered Dietitian
- License
- 677
- Practice address
- 5 Via Sur
La Cima
Trujillo Alto, PR 00976-6159 - Phone
- (787) 755-6201
- NPI assigned
- Jan 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nutrition Registered Dietitian | 133VN1004X | 677 | PR | Primary |
Addresses
Primary practice location
5 Via Sur
La Cima
Trujillo Alto, PR 00976-6159
Mailing address
5 Via Sur
La Cima
Trujillo Alto, PR 00976-6159
Phone (787) 755-6201
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)
- Enrolled
- Credentials
- Master of Business Administration
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 677 | PR | MD | Pediatric Nutrition Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992851778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 VIA SUR",
"address_2": "LA CIMA",
"city": "TRUJILLO ALTO",
"state": "PR",
"postal_code": "009766159",
"telephone_number": "787-755-6201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 VIA SUR",
"address_2": "LA CIMA",
"city": "TRUJILLO ALTO",
"state": "PR",
"postal_code": "009766159",
"telephone_number": "787-755-6201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "ELBA",
"middle_name": "ELISA",
"name_prefix": "Mrs.",
"credential": "LD,RD,MBA,CPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1004X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Pediatric",
"state": "PR",
"license": "677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Trujillo Alto, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.