Provider Demographics
NPI:1528377710
Name:FAMILY NUTRITION CENTER OF OVIEDO LLC
Entity Type:Organization
Organization Name:FAMILY NUTRITION CENTER OF OVIEDO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MILANA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-716-9382
Mailing Address - Street 1:2984 ALAFAYA TRL
Mailing Address - Street 2:SUITE 2020
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-7628
Mailing Address - Country:US
Mailing Address - Phone:407-588-1650
Mailing Address - Fax:407-588-1647
Practice Address - Street 1:2984 ALAFAYA TRL
Practice Address - Street 2:SUITE 2020
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-7628
Practice Address - Country:US
Practice Address - Phone:407-588-1650
Practice Address - Fax:407-588-1647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-05
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes132700000XDietary & Nutritional Service ProvidersDietary ManagerGroup - Single Specialty