Provider Demographics
NPI:1245104991
Name:AMEZOLA NUTRITION, LLC
Entity type:Organization
Organization Name:AMEZOLA NUTRITION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:ALEJANDRA
Authorized Official - Middle Name:FRIDA
Authorized Official - Last Name:AMEZOLA-VELAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:559-498-9802
Mailing Address - Street 1:3800 N LAMAR BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-0003
Mailing Address - Country:US
Mailing Address - Phone:559-498-9802
Mailing Address - Fax:
Practice Address - Street 1:3800 N LAMAR BLVD STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-0003
Practice Address - Country:US
Practice Address - Phone:559-498-9802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-03
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty