Provider Demographics
NPI:1962652453
Name:CARRASQUILLO, FRANCIS (LND)
Entity type:Individual
Prefix:MS
First Name:FRANCIS
Middle Name:
Last Name:CARRASQUILLO
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 526
Mailing Address - Street 2:CANOVANAS
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-0526
Mailing Address - Country:US
Mailing Address - Phone:787-642-5473
Mailing Address - Fax:
Practice Address - Street 1:STREET 4 QUINTAS DE CANOVANAS
Practice Address - Street 2:R-19
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729-0526
Practice Address - Country:US
Practice Address - Phone:787-642-5473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-22
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1363133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist