Healthcare Provider Details

I. General information

NPI: 1710042692
Provider Name (Legal Business Name): MEGEN LEIGH ERWINE RDN, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGEN LEIGH MILINSKI

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 04/22/2021
Certification Date: 04/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 HEALING WAY SUITE 101
WESLEY CHAPEL FL
33543
US

IV. Provider business mailing address

10480 LUCAYA DRIVE
TAMPA FL
33647
US

V. Phone/Fax

Practice location:
  • Phone: 813-929-5368
  • Fax: 724-282-3004
Mailing address:
  • Phone: 724-422-2419
  • Fax: 724-282-3004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberND6062
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number963775
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: