Provider Demographics
NPI:1245049659
Name:VECIN, MICHAEL ENRIQUE (RD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ENRIQUE
Last Name:VECIN
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3540 SW 104TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-3718
Mailing Address - Country:US
Mailing Address - Phone:786-632-5522
Mailing Address - Fax:786-632-5557
Practice Address - Street 1:3540 SW 104TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-3718
Practice Address - Country:US
Practice Address - Phone:786-632-5522
Practice Address - Fax:786-632-5557
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-01
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13789133V00000X
NY012432133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered