Provider Demographics
NPI:1104343342
Name:MARRERO GONZALEZ, ALANA MINNEE (LND MHSN)
Entity type:Individual
Prefix:
First Name:ALANA
Middle Name:MINNEE
Last Name:MARRERO GONZALEZ
Suffix:
Gender:F
Credentials:LND MHSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:371 CALLE JOSE DE DIEGO
Mailing Address - Street 2:
Mailing Address - City:RIO PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00923
Mailing Address - Country:US
Mailing Address - Phone:787-767-5100
Mailing Address - Fax:
Practice Address - Street 1:31 CALLE HEAVENLY VW
Practice Address - Street 2:
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778-9725
Practice Address - Country:US
Practice Address - Phone:787-371-5624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1516133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education