Healthcare Provider Details
I. General information
NPI: 1467954446
Provider Name (Legal Business Name): JENNA MERYL APPEL RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/06/2018
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1229 NW 40TH AVE
LAUDERHILL FL
33313-5801
US
IV. Provider business mailing address
6015 WASHINGTON ST FL 2
HOLLYWOOD FL
33023-1316
US
V. Phone/Fax
- Phone: 954-583-4710
- Fax:
- Phone: 954-266-2999
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | ND8380 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: