Healthcare Provider Details

I. General information

NPI: 1912848714
Provider Name (Legal Business Name): ALLISON NICHOLE MAYER RDN, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6366 NW 171ST ST
HIALEAH FL
33015-4675
US

IV. Provider business mailing address

6366 NW 171ST ST
HIALEAH FL
33015-4675
US

V. Phone/Fax

Practice location:
  • Phone: 786-501-0247
  • Fax:
Mailing address:
  • Phone: 786-501-0247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberND15013
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: