Provider Demographics
NPI:1053611723
Name:FIGUEROA, GLENDALIS (LND)
Entity type:Individual
Prefix:
First Name:GLENDALIS
Middle Name:
Last Name:FIGUEROA
Suffix:
Gender:F
Credentials:LND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. SANTA TERESITA
Mailing Address - Street 2:#4803 SANTA LUCIA
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730-4529
Mailing Address - Country:US
Mailing Address - Phone:787-486-8930
Mailing Address - Fax:787-844-7515
Practice Address - Street 1:URB. SANTA TERESITA
Practice Address - Street 2:SANTA LUCIA STREET #4803
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730-4529
Practice Address - Country:US
Practice Address - Phone:787-486-8930
Practice Address - Fax:787-844-7515
Is Sole Proprietor?:No
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1477133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education