Healthcare Provider Details

I. General information

NPI: 1144655994
Provider Name (Legal Business Name): BRIANA ZOLAK HOLISTIC NUTRITION
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRIANA MICHEL

II. Dates (important events)

Enumeration Date: 09/12/2013
Last Update Date: 09/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20134 HERITAGE POINT DR
TAMPA FL
33647-3341
US

IV. Provider business mailing address

20134 HERITAGE POINT DR
TAMPA FL
33647
US

V. Phone/Fax

Practice location:
  • Phone: 412-335-3144
  • Fax:
Mailing address:
  • Phone: 412-335-3144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: