Healthcare Provider Details

I. General information

NPI: 1003005422
Provider Name (Legal Business Name): ANDREA MORGANSTEIN RD, CDCES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2007
Last Update Date: 11/07/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 S UNIVERSITY DR #228
DAVIE FL
33328
US

IV. Provider business mailing address

3057 TORTOLA WAY
HOLLYWOOD FL
33024
US

V. Phone/Fax

Practice location:
  • Phone: 954-947-0027
  • Fax: 954-272-7968
Mailing address:
  • Phone: 954-243-1222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number3765
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: