Doctor Name: | MRS. MIREYDA BAEZ |
NPI Number: | 1023212255 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LND |
License Number: | 1339 |
Business Practice Address: | Urb Villas De San Agustin Ave San Agustin D21 Bayamon, PR - 009592040 |
Business Phone Number: | 7874091929 |
Business Fax Number: | |
Mailing Address: | Urb Villas De San Agustin, Ave San Agustin D21 BAYAMON |
State: | PR |
Postal Code: | 009592040 |
Phone Number: | 7874091929 |
Fax Number: | |
NPI Enumeration Date: | 06/12/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133NN1002X |
License Number: | 1339 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Nutritionist |
Taxonomy Specialization: | Nutrition, Education |
Taxonomy Definition: |