Provider Demographics
NPI:1801620513
Name:MINDBODYSOL NUTRITION LLC
Entity type:Organization
Organization Name:MINDBODYSOL NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER /CEO
Authorized Official - Prefix:
Authorized Official - First Name:SOL
Authorized Official - Middle Name:
Authorized Official - Last Name:FIGUEROA
Authorized Official - Suffix:
Authorized Official - Credentials:RD/LDN, CPT
Authorized Official - Phone:863-399-1267
Mailing Address - Street 1:3190 N TWIN LAKES DR
Mailing Address - Street 2:
Mailing Address - City:AVON PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33825-9262
Mailing Address - Country:US
Mailing Address - Phone:863-399-1267
Mailing Address - Fax:
Practice Address - Street 1:3190 N TWIN LAKES DR
Practice Address - Street 2:
Practice Address - City:AVON PARK
Practice Address - State:FL
Practice Address - Zip Code:33825-9262
Practice Address - Country:US
Practice Address - Phone:863-399-1267
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-27
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight ManagementGroup - Single Specialty