Healthcare Provider Details

I. General information

NPI: 1225932049
Provider Name (Legal Business Name): HANNAH BETHMAN LDN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1317 EDGEWATER DR # 4894
ORLANDO FL
32804-6350
US

IV. Provider business mailing address

1317 EDGEWATER DR # 4894
ORLANDO FL
32804-6350
US

V. Phone/Fax

Practice location:
  • Phone: 239-321-2240
  • Fax:
Mailing address:
  • Phone: 239-321-2240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberND15481
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: