MEDICARE: HUMAN ELEMENT NUTRITION LLC

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	:	1831793314
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUMAN ELEMENT NUTRITION LLC

Provider Business Mailing Address
First Line	:	19734 PRESERVATION MEWS
Second Line	:
City	:	MONTGOMERY VILLAGE
State	:	MD
Zip	:	20886-1906
Country	:	US
Telephone Number	:	850-354-0270
Fax Number	:

Provider Business Practice Location Address
First Line	:	19734 PRESERVATION MEWS
Second Line	:
City	:	MONTGOMERY VILLAGE
State	:	MD
Zip	:	20886-1906
Country	:	US
Telephone Number	:	850-354-0270
Fax Number	:

Authorized Official
Title or Position	:	REGISTERED DIETITIAN
Name	:	BLAIR PATRICK SOLBERGER
Credential	:	MS RD CSSD
Telephone Number	:	850-354-0270

Provider Enumeration Date	:	11/25/2020
Last Update Date	:	12/19/2024

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