Provider Demographics
NPI:1194318519
Name:KCN-NUTRICION CON BIENESTAR LLC
Entity type:Organization
Organization Name:KCN-NUTRICION CON BIENESTAR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRADORA
Authorized Official - Prefix:
Authorized Official - First Name:KARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAUDIO NAVARRO
Authorized Official - Suffix:
Authorized Official - Credentials:NUTRICIONISTA
Authorized Official - Phone:787-469-4784
Mailing Address - Street 1:PO BOX 463
Mailing Address - Street 2:
Mailing Address - City:AGUAS BUENAS
Mailing Address - State:PR
Mailing Address - Zip Code:00703-0463
Mailing Address - Country:US
Mailing Address - Phone:787-469-4784
Mailing Address - Fax:
Practice Address - Street 1:BO CANABON SECTOR LA UNION
Practice Address - Street 2:CARR 156 KM 55.3
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-0070
Practice Address - Country:US
Practice Address - Phone:787-469-4784
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-17
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty