Provider Demographics
NPI:1184307613
Name:VIVA LA COMIDA
Entity type:Organization
Organization Name:VIVA LA COMIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:602-245-7924
Mailing Address - Street 1:1801 E CAMELBACK RD STE 102
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4165
Mailing Address - Country:US
Mailing Address - Phone:602-245-7924
Mailing Address - Fax:
Practice Address - Street 1:4822 W ST ANNE AVE
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-6318
Practice Address - Country:US
Practice Address - Phone:602-245-7924
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty