Healthcare Provider Details

I. General information

NPI: 1942007737
Provider Name (Legal Business Name): NUTRITION BY SERENA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2025
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2332 BRIX ST
ORLANDO FL
32804-4755
US

IV. Provider business mailing address

2332 BRIX ST
ORLANDO FL
32804-4755
US

V. Phone/Fax

Practice location:
  • Phone: 914-629-3183
  • Fax:
Mailing address:
  • Phone: 914-629-3183
  • 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: SERENA CATHERINE PRATT
Title or Position: REGISTERED DIETITIAN NUTRITIONIST
Credential: RDN
Phone: 914-629-3183