Basic Information
| Provider Information | |||||||||
| NPI: | 1851511901 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SARDINA ORTIZ | ||||||||
| FirstName: | DALGIS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1590 CALLE EARTH | ||||||||
| Address2: | URB. GOLDEN HILLS | ||||||||
| City: | DORADO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00646 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7874747346 | ||||||||
| FaxNumber: | 7874747346 | ||||||||
| Practice Location | |||||||||
| Address1: | URB GOLDEN HILLS | ||||||||
| Address2: | 1590 CALLE EARTH | ||||||||
| City: | DORADO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00646 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7874747346 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/30/2007 | ||||||||
| LastUpdateDate: | 01/17/2012 | ||||||||
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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 | 1047 | PR | N | Dietary & Nutritional Service Providers | Nutritionist | 133V00000X | 1047 | PR | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.