=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235933607
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AM NUTRITION AND HEALTH LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/03/2025
-----------------------------------------------------
Last Update Date | 12/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3625 NW 82ND AVE STE 400D1
-----------------------------------------------------
City | DORAL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33166-6652
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-273-7407
-----------------------------------------------------
Fax | 833-457-1638
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12203 NW 23RD PL
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33167-1489
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-638-3717
-----------------------------------------------------
Fax | 833-457-1638
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ASTRID MOLLER GONZALEZ
-----------------------------------------------------
Credential | MS, CNS, LDN
-----------------------------------------------------
Telephone | 804-638-3717
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133N00000X
-----------------------------------------------------
Taxonomy Name | Nutritionist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------