MEDICARE: JOANNA STORM-LIU R.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1376492850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNA STORM-LIU R.D.

Provider Business Mailing Address
First Line	:	1531 PIPER DUNES PL
Second Line	:
City	:	FERNANDINA BEACH
State	:	FL
Zip	:	32034-6619
Country	:	US
Telephone Number	:	610-888-9680
Fax Number	:

Provider Business Practice Location Address
First Line	:	1531 PIPER DUNES PL
Second Line	:
City	:	FERNANDINA BEACH
State	:	FL
Zip	:	32034-6619
Country	:	US
Telephone Number	:	610-888-9680
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2026
Last Update Date	:	01/27/2026

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