Provider Demographics
NPI:1932743861
Name:SUMA VITTA LLC
Entity Type:Organization
Organization Name:SUMA VITTA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUMA
Authorized Official - Middle Name:
Authorized Official - Last Name:VITTA
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LD, CDE
Authorized Official - Phone:205-540-0269
Mailing Address - Street 1:5201 SOUTHCREST TER
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-5110
Mailing Address - Country:US
Mailing Address - Phone:205-540-0269
Mailing Address - Fax:
Practice Address - Street 1:5201 SOUTHCREST TER
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-5110
Practice Address - Country:US
Practice Address - Phone:205-540-0269
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty