Healthcare Provider Details

I. General information

NPI: 1861383788
Provider Name (Legal Business Name): MVNUTRITION CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2025
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 S DIXIE HWY STE 206A
MIAMI FL
33133-2460
US

IV. Provider business mailing address

3071 SW 4TH ST
MIAMI FL
33135-2701
US

V. Phone/Fax

Practice location:
  • Phone: 786-506-1945
  • Fax:
Mailing address:
  • Phone: 786-506-1945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: MARIA VALLASCIANI
Title or Position: PRESIDENT
Credential:
Phone: 786-506-1945