Provider Demographics
NPI:1841996089
Name:SUGIMOTO, NATASHA NICOLE (RDN, LD)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:NICOLE
Last Name:SUGIMOTO
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:NATASHA
Other - Middle Name:NICOLE
Other - Last Name:STEINER PINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN, LD
Mailing Address - Street 1:13120 SW 107TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-3400
Mailing Address - Country:US
Mailing Address - Phone:305-432-1871
Mailing Address - Fax:
Practice Address - Street 1:13120 SW 107TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-3400
Practice Address - Country:US
Practice Address - Phone:305-432-1871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86146983133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN37003530AOtherDIETITIAN LICENSE
IA118633OtherDIETITIAN LICENSE
MDDX5655OtherDIETITIAN LICENSE
FLND9998OtherDIETITIAN LICENSE
NH1330OtherDIETITIAN LICENSE
86146983OtherCDR
KY281046OtherDIETITIAN LICENSE
DCDI200001357OtherDIETITIAN LICENSE
AK197850OtherDIETITIAN LICENSE
PADN007838OtherDIETITIAN LICENSE