Provider Demographics
NPI:1508199951
Name:BRUNETTI, RENEE (LD/N)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:
Last Name:BRUNETTI
Suffix:
Gender:F
Credentials:LD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10934 NW 71ST CT
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33076-3819
Mailing Address - Country:US
Mailing Address - Phone:613-026-9605
Mailing Address - Fax:
Practice Address - Street 1:10934 NW 71ST CT
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33076-3819
Practice Address - Country:US
Practice Address - Phone:561-302-6960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5068133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education