NUTRITION CLINIC LLC NPI 1760038939

NPI Information

  • NPI: 1760038939
  • Provider Name: NUTRITION CLINIC LLC
  • Classification: Dietitian, Registered - 133V00000X
  • Entity Type: Organization
  • Doing Business As: THE NUTRITION CLINIC
  • Address: 10570 S US HIGHWAY 1 STE 300
    PORT ST LUCIE, FL
    ZIP 34952
  • Phone: (772) 878-8227

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NPI Details

NUTRITION CLINIC LLC is a dietitian registered in Port St Lucie, FL. The provider is a Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation. NUTRITION CLINIC LLC NPI is 1760038939. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As The Nutrition Clinic.

The provider's business location address is:

10570 S US HIGHWAY 1 STE 300
PORT ST LUCIE, FL
ZIP 34952-606
Phone: (772) 878-8227
Fax: (772) 324-7863

The provider's authorized official is Phara Jourdan Taylor .
The authorized official title is Ceo and has the following contact phone number (772) 800-3014.

The enumeration date for this NPI number is 8/14/2019 and was last updated on 12/28/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1133V00000XDietitian, RegisteredYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1005491300MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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