Provider Demographics
NPI:1255094124
Name:FUZY, CHRISTOPHER F (MS,RD,LD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:F
Last Name:FUZY
Suffix:
Gender:M
Credentials:MS,RD,LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1741 CORAL GARDENS DR
Mailing Address - Street 2:
Mailing Address - City:WILTON MANORS
Mailing Address - State:FL
Mailing Address - Zip Code:33334-4371
Mailing Address - Country:US
Mailing Address - Phone:561-929-1488
Mailing Address - Fax:954-200-6156
Practice Address - Street 1:1741 CORAL GARDENS DR
Practice Address - Street 2:
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33334-4371
Practice Address - Country:US
Practice Address - Phone:561-929-1488
Practice Address - Fax:954-200-6156
Is Sole Proprietor?:No
Enumeration Date:2021-10-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8733133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered