Provider Demographics
NPI:1386299394
Name:PEREZ GARCIA, JOANGELY (LND)
Entity type:Individual
Prefix:MRS
First Name:JOANGELY
Middle Name:
Last Name:PEREZ GARCIA
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:PO BOX 942
Mailing Address - Street 2:
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795-0942
Mailing Address - Country:US
Mailing Address - Phone:787-460-9551
Mailing Address - Fax:
Practice Address - Street 1:A2 CALLE 2
Practice Address - Street 2:URB ESTANCIAS DEL RIO
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795-0079
Practice Address - Country:US
Practice Address - Phone:787-248-4246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2092133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist