Provider Demographics
NPI:1063161271
Name:VENDRELL FELIX, ALONDRA M (LND)
Entity type:Individual
Prefix:
First Name:ALONDRA
Middle Name:M
Last Name:VENDRELL FELIX
Suffix:
Gender:F
Credentials:LND
Other - Prefix:
Other - First Name:ALONDRA
Other - Middle Name:M
Other - Last Name:VENDRELL FELIX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LND
Mailing Address - Street 1:BASE RAMEY
Mailing Address - Street 2:CIRCULO C 202 A
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603
Mailing Address - Country:US
Mailing Address - Phone:787-202-4797
Mailing Address - Fax:
Practice Address - Street 1:BASE RAMEY
Practice Address - Street 2:CIRCULO C 202 A
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-202-4797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-23
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2153133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty