Provider Demographics
NPI:1679726178
Name:GUAL, GERALDINE (LND)
Entity type:Individual
Prefix:MRS
First Name:GERALDINE
Middle Name:
Last Name:GUAL
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 1:204-8 CALLE 435
Mailing Address - Street 2:VILLA CAROLINA
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985-3019
Mailing Address - Country:US
Mailing Address - Phone:787-977-2145
Mailing Address - Fax:787-977-2134
Practice Address - Street 1:204-8 CALLE 435
Practice Address - Street 2:VILLA CAROLINA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985-3019
Practice Address - Country:US
Practice Address - Phone:787-977-2145
Practice Address - Fax:787-977-2134
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1412133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education