Healthcare Provider Details

I. General information

NPI: 1396070017
Provider Name (Legal Business Name): HEBNI NUTRITION CONSULTANTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2009
Last Update Date: 10/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2009 W CENTRAL BLVD
ORLANDO FL
32805-2124
US

IV. Provider business mailing address

2009 W CENTRAL BLVD
ORLANDO FL
32805-2124
US

V. Phone/Fax

Practice location:
  • Phone: 407-872-1333
  • Fax: 407-872-7135
Mailing address:
  • Phone: 407-872-1333
  • Fax: 407-872-7135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberBUS-0009485
License Number StateFL

VIII. Authorized Official

Name: MRS. RONIECE ANITA WEAVER
Title or Position: EXECUTIVE DIRECTOR
Credential: MS RD LD
Phone: 407-872-1333