Provider Demographics
NPI:1154050995
Name:MESSINA, MEGAN ROSE (RDN, CDN)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:ROSE
Last Name:MESSINA
Suffix:
Gender:F
Credentials:RDN, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 SW 27TH AVE APT 1007
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-3013
Mailing Address - Country:US
Mailing Address - Phone:321-507-0566
Mailing Address - Fax:
Practice Address - Street 1:2600 SW 27TH AVE APT 1007
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-3013
Practice Address - Country:US
Practice Address - Phone:321-507-0566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11075133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered