Healthcare Provider Details

I. General information

NPI: 1467875708
Provider Name (Legal Business Name): ALYSSA PUORRO RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2014
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date: 07/14/2015
Reactivation Date: 02/03/2020

III. Provider practice location address

1000 BRICKELL AVE STE 715
MIAMI FL
33131-3047
US

IV. Provider business mailing address

1000 BRICKELL AVE STE 715
MIAMI FL
33131-3047
US

V. Phone/Fax

Practice location:
  • Phone: 949-416-3856
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1085029
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: