Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 532 | PR |
NPI | 1659770352 |
---|---|
Provider Name | Dr. Alexandra M Pedroza |
First Address | San Juan, PR 00926 |
Second Address | San Juan, PR 00926-6439 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2014 |
Last Update Date | 19/08/2014 |