Healthcare Provider Details

I. General information

NPI: 1609237031
Provider Name (Legal Business Name): CHRISTI BUCK RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2016
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1116 33RD AVE SW
VERO BEACH FL
32968-5048
US

IV. Provider business mailing address

1116 33RD AVE SW
VERO BEACH FL
32968-5048
US

V. Phone/Fax

Practice location:
  • Phone: 772-971-9006
  • Fax:
Mailing address:
  • Phone: 772-971-9006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License NumberND 7447
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License NumberND 7447
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License NumberND 7447
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberND 7447
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: