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General NPI Number Information
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NPI Number | 1033704259
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Entity Type | Organization
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Legal Business Name | 3 IN 1 NUTRITION LLC
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Dates
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Enumeration Date | 03/09/2021
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Last Update Date | 03/09/2021
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Provider Practice Location Address
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Address Line | 7901 4TH ST N STE 4000
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4305
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Country | US
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Telephone | 813-693-2182
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Fax |
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Provider Business Mailing Address
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Address Line | 7901 4TH ST N STE 4000
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4305
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Country | US
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Telephone | 813-693-2182
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Fax |
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Authorized Official
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Title or Position | CEO/ FOUNDER
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Name | CIARA DOVE
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Credential | RD
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Telephone | 904-510-9060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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