Healthcare Provider Details

I. General information

NPI: 1629972716
Provider Name (Legal Business Name): LORENA NAVA REGISTER DIETITIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3131 NE 188TH ST APT 2806
AVENTURA FL
33180-2777
US

IV. Provider business mailing address

3131 NE 188TH ST APT 2806
AVENTURA FL
33180-2777
US

V. Phone/Fax

Practice location:
  • Phone: 305-331-0935
  • Fax:
Mailing address:
  • Phone: 305-331-0935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86103191
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: