Provider Demographics
NPI:1457774051
Name:BAERTSCHI, AMY (MS, RD-N)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:BAERTSCHI
Suffix:
Gender:F
Credentials:MS, RD-N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6330 SW 107TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-4050
Mailing Address - Country:US
Mailing Address - Phone:415-806-8743
Mailing Address - Fax:
Practice Address - Street 1:6330 SW 107TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-4050
Practice Address - Country:US
Practice Address - Phone:415-806-8743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-03
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA928944133V00000X
FLND7802133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered