Basic Information
| Provider Information | |||||||||
| NPI: | 1750548780 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZAMBRANA | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | LND MPA CNS | ||||||||
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| Mailing Information | |||||||||
| Address1: | VIA PEDREGAL COND MONTECILLOS # I | ||||||||
| Address2: | APT 402 | ||||||||
| City: | TRUJILLO ALTO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009766080 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877602448 | ||||||||
| FaxNumber: | 7877602448 | ||||||||
| Practice Location | |||||||||
| Address1: | AVE SANCHEZ OSORIO | ||||||||
| Address2: | #5A-3 | ||||||||
| City: | CAROLINA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009833226 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877622380 | ||||||||
| FaxNumber: | 7877602448 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2008 | ||||||||
| LastUpdateDate: | 05/19/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133N00000X | 098 | PR | Y | Dietary & Nutritional Service Providers | Nutritionist |
No ID Information.