Provider Demographics
NPI:1548670078
Name:ARCE, ANGELINE MARIE (LND)
Entity type:Individual
Prefix:
First Name:ANGELINE
Middle Name:MARIE
Last Name:ARCE
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 1:190-9 CALLE 521
Mailing Address - Street 2:URB VILLA CAROLINA
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985-0000
Mailing Address - Country:US
Mailing Address - Phone:787-627-2361
Mailing Address - Fax:
Practice Address - Street 1:190-9 CALLE 521
Practice Address - Street 2:URB VILLA CAROLINA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985-0000
Practice Address - Country:US
Practice Address - Phone:787-627-2361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-06
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1661133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered