Provider Demographics
NPI:1740686872
Name:PLATEFUL OF YUM LLC
Entity type:Organization
Organization Name:PLATEFUL OF YUM LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:TITILAYO
Authorized Official - Middle Name:
Authorized Official - Last Name:AYANWOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MPH, RD, LD
Authorized Official - Phone:512-363-9571
Mailing Address - Street 1:6901A N 9TH AVE # 588
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-6638
Mailing Address - Country:US
Mailing Address - Phone:512-363-9571
Mailing Address - Fax:
Practice Address - Street 1:25060 GLENBROOKE DR
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-2514
Practice Address - Country:US
Practice Address - Phone:512-363-9571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-18
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty