Provider Demographics
NPI:1861719684
Name:COSME, ANAMARIE (LND, RD)
Entity type:Individual
Prefix:
First Name:ANAMARIE
Middle Name:
Last Name:COSME
Suffix:
Gender:F
Credentials:LND, RD
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 191227
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-1227
Mailing Address - Country:US
Mailing Address - Phone:787-758-2000
Mailing Address - Fax:787-771-7426
Practice Address - Street 1:AVE. PONCE DE LEON PARADA 37.5
Practice Address - Street 2:
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-758-2000
Practice Address - Fax:787-771-7426
Is Sole Proprietor?:No
Enumeration Date:2010-05-04
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1548133N00000X
PR982621133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist