Healthcare Provider Details

I. General information

NPI: 1952193401
Provider Name (Legal Business Name): ROOTS YOGA AND NUTRITION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2025
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 SPINNAKERS REACH DR
PONTE VEDRA BEACH FL
32082-3434
US

IV. Provider business mailing address

447 NORTH ST
NEW HAVEN VT
05472-2010
US

V. Phone/Fax

Practice location:
  • Phone: 860-371-5881
  • Fax:
Mailing address:
  • Phone: 860-371-5881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH OROSZ
Title or Position: OWNER
Credential: MS, CNS, LDN
Phone: 860-371-5881