Healthcare Provider Details

I. General information

NPI: 1821568775
Provider Name (Legal Business Name): METABOLISM CHALLENGER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2018
Last Update Date: 12/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14711 SW 150TH ST
MIAMI FL
33196-2369
US

IV. Provider business mailing address

14711 SW 150TH ST
MIAMI FL
33196-2369
US

V. Phone/Fax

Practice location:
  • Phone: 786-384-2235
  • Fax:
Mailing address:
  • Phone: 786-384-2235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN1003X
TaxonomyNutrition Support Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: DR. MONICA MUSIET
Title or Position: PRESIDENT
Credential: PHD, MS, BC, RN, CDE
Phone: 786-384-2235