Provider Demographics
NPI:1235788472
Name:WORLDWIDE DIABETIC HEALTH & NUTRITION CENTER LLC
Entity Type:Organization
Organization Name:WORLDWIDE DIABETIC HEALTH & NUTRITION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:AMATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-650-4610
Mailing Address - Street 1:11 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-3727
Mailing Address - Country:US
Mailing Address - Phone:954-650-4610
Mailing Address - Fax:
Practice Address - Street 1:11 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33460-3727
Practice Address - Country:US
Practice Address - Phone:954-650-4610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-10
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy