Healthcare Provider Details

I. General information

NPI: 1689186959
Provider Name (Legal Business Name): INTUITIVE NUTRITION MIAMI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2017
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 S SHORE DR APT 4C
MIAMI BEACH FL
33141-3984
US

IV. Provider business mailing address

130 S SHORE DR APT 4C
MIAMI BEACH FL
33141-3984
US

V. Phone/Fax

Practice location:
  • Phone: 305-965-7546
  • Fax:
Mailing address:
  • Phone: 305-965-7546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberND8148
License Number StateFL

VIII. Authorized Official

Name: CHRISTINE TELLEZ
Title or Position: OWNER
Credential: MS, RD, LD
Phone: 305-965-7546