Provider Demographics
NPI:1376793893
Name:HEALTH NUT NUTRITION & WELLNESS CONSULTANTS PA
Entity Type:Organization
Organization Name:HEALTH NUT NUTRITION & WELLNESS CONSULTANTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:BERROCAL
Authorized Official - Suffix:
Authorized Official - Credentials:RD, MS
Authorized Official - Phone:305-490-5070
Mailing Address - Street 1:11001 SW 26TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-2303
Mailing Address - Country:US
Mailing Address - Phone:305-490-5070
Mailing Address - Fax:305-553-8563
Practice Address - Street 1:11001 SW 26TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-2303
Practice Address - Country:US
Practice Address - Phone:305-490-5070
Practice Address - Fax:305-553-8563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-19
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND 5394133NN1002X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty