Healthcare Provider Details

I. General information

NPI: 1114526209
Provider Name (Legal Business Name): SCIENTIFIC NUTRITION INTERNATIONAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2020
Last Update Date: 10/20/2020
Certification Date: 10/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6295 SUNSET DR
SOUTH MIAMI FL
33143-4804
US

IV. Provider business mailing address

6295 SUNSET DR
SOUTH MIAMI FL
33143-4804
US

V. Phone/Fax

Practice location:
  • Phone: 786-238-7533
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: SABRINA HERNANDEZ
Title or Position: PRESIDENT
Credential: RD, CDE
Phone: 786-238-7533