Provider Demographics
NPI:1548453921
Name:SILVA MESTRE, DEBBIE M (LND ( DIETITIAN))
Entity type:Individual
Prefix:
First Name:DEBBIE
Middle Name:M
Last Name:SILVA MESTRE
Suffix:
Gender:F
Credentials:LND ( DIETITIAN)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. VILLA HUMACAO
Mailing Address - Street 2:CALLE 15 B-25
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791
Mailing Address - Country:US
Mailing Address - Phone:787-852-3687
Mailing Address - Fax:
Practice Address - Street 1:CALLE 15 B-25
Practice Address - Street 2:URB. VILLA HUMACAO
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791
Practice Address - Country:US
Practice Address - Phone:787-852-3687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-20
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1389133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist