Provider Demographics
NPI:1932568656
Name:PLANOS NUTRITION, INC
Entity Type:Organization
Organization Name:PLANOS NUTRITION, INC
Other - Org Name:VIVE NUTRITION, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:EDUARDO
Authorized Official - Last Name:AYESTA HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LD
Authorized Official - Phone:812-604-0958
Mailing Address - Street 1:1205 N FRANKLIN ST STE 332
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-3313
Mailing Address - Country:US
Mailing Address - Phone:812-604-0958
Mailing Address - Fax:
Practice Address - Street 1:1205 N FRANKLIN ST STE 332
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-3313
Practice Address - Country:US
Practice Address - Phone:812-604-0958
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-23
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND6920133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty