Provider Demographics
NPI:1396227708
Name:INSPIRED NUTRITION
Entity Type:Organization
Organization Name:INSPIRED NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN NUTRITIONIST
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSCO
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, CSO, LDN
Authorized Official - Phone:973-557-8135
Mailing Address - Street 1:4729 SE GLENRIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-2548
Mailing Address - Country:US
Mailing Address - Phone:973-557-8135
Mailing Address - Fax:
Practice Address - Street 1:4729 SE GLENRIDGE TRL
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-2548
Practice Address - Country:US
Practice Address - Phone:973-557-8135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8794133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty