Provider Demographics
NPI:1942954110
Name:THE HAITIAN NUTRITIONIST LLC
Entity Type:Organization
Organization Name:THE HAITIAN NUTRITIONIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:OLGUYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ-FRAGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-377-4740
Mailing Address - Street 1:7145 SW 42ND TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-4605
Mailing Address - Country:US
Mailing Address - Phone:786-377-4740
Mailing Address - Fax:786-822-5533
Practice Address - Street 1:7145 SW 42ND TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4605
Practice Address - Country:US
Practice Address - Phone:786-205-7586
Practice Address - Fax:786-822-5533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-07
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, PediatricGroup - Single Specialty
No133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight ManagementGroup - Single Specialty
No133VN1301XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, OncologyGroup - Single Specialty