Provider Demographics
NPI:1659127058
Name:WAKAI, MEGAN (RDN, LDN, MPH)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:WAKAI
Suffix:
Gender:F
Credentials:RDN, LDN, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 S DOUGLAS RD APT 1413
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-7569
Mailing Address - Country:US
Mailing Address - Phone:248-909-8084
Mailing Address - Fax:
Practice Address - Street 1:888 S DOUGLAS RD APT 1413
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-7569
Practice Address - Country:US
Practice Address - Phone:248-909-8084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-25
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11139133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered