Provider Demographics
NPI:1265777858
Name:SIESTA NUTRITION & VITAMINS INC.
Entity type:Organization
Organization Name:SIESTA NUTRITION & VITAMINS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:
Authorized Official - Last Name:MASTROTOTARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-929-0884
Mailing Address - Street 1:1882 STICKNEY POINT RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-8847
Mailing Address - Country:US
Mailing Address - Phone:941-929-0884
Mailing Address - Fax:941-929-0864
Practice Address - Street 1:1882 STICKNEY POINT RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-8847
Practice Address - Country:US
Practice Address - Phone:941-929-0884
Practice Address - Fax:941-929-0864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-07
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy