Healthcare Provider Details

I. General information

NPI: 1275452153
Provider Name (Legal Business Name): BERRY WELL NUTRITION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5350 CASA REAL DR
DELRAY BEACH FL
33484-6667
US

IV. Provider business mailing address

5350 CASA REAL DR
DELRAY BEACH FL
33484-6667
US

V. Phone/Fax

Practice location:
  • Phone: 843-324-0221
  • Fax: 954-884-8784
Mailing address:
  • Phone:
  • Fax: 954-884-8784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: JACLYN PACIARONI KLAUDER
Title or Position: OWNER
Credential: KLAUDER
Phone: 843-324-0221