Provider Demographics
NPI:1336779123
Name:XP SPORTS INTERNATIONAL
Entity Type:Organization
Organization Name:XP SPORTS INTERNATIONAL
Other - Org Name:YOUR DIABETES INSIDER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TZEEL
Authorized Official - Suffix:
Authorized Official - Credentials:MPH, RD, LDN, CSCS
Authorized Official - Phone:262-302-6476
Mailing Address - Street 1:15319 WIND WHISPER DR
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-1794
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1209 E CUMBERLAND AVE UNIT 604
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-4257
Practice Address - Country:US
Practice Address - Phone:262-302-6476
Practice Address - Fax:813-491-1464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-21
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL86153304OtherACADEMY OF NUTRITION AND DIETETICS
FLND-9009OtherFLORIDA LICENSED DIETITIAN