Healthcare Provider Details

I. General information

NPI: 1285890301
Provider Name (Legal Business Name): JULIE E HAUGEN MS, RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2008
Last Update Date: 07/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1688 MERIDIAN AVE 10TH FLOOR
MIAMI BEACH FL
33139-2710
US

IV. Provider business mailing address

1000 MICHIGAN AVE #606
MIAMI BEACH FL
33139-4821
US

V. Phone/Fax

Practice location:
  • Phone: 305-490-3311
  • Fax: 305-647-6471
Mailing address:
  • Phone: 305-490-3311
  • Fax: 305-647-6471

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberND 4566
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: