Provider Demographics
NPI:1972717031
Name:HATCH, VICKI (MS RDN, LDN, CDE)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:
Last Name:HATCH
Suffix:
Gender:F
Credentials:MS RDN, LDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3350 NE 192ND ST APT 3P
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2420
Mailing Address - Country:US
Mailing Address - Phone:305-527-5579
Mailing Address - Fax:
Practice Address - Street 1:2875 NE 191ST ST STE 552
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2801
Practice Address - Country:US
Practice Address - Phone:954-840-7296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND2887133V00000X, 133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered