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General NPI Number Information
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NPI Number | 1316549744
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Entity Type | Individual
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Provider Name | STEPHANIE MARIE MEZERHANE RD
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Gender | Female
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Dates
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Enumeration Date | 11/10/2020
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Last Update Date | 11/10/2020
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Provider Practice Location Address
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Address Line | 11030 N KENDALL DR STE 100
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City | MIAMI
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State | FL
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Zip | 33176-8814
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Country | US
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Telephone | 305-994-1825
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Fax | 305-508-5519
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Provider Business Mailing Address
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Address Line | 14602 SW 21ST ST
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City | MIAMI
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State | FL
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Zip | 33175-7505
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Country | US
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Telephone | 954-790-2101
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | ND10129
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License Number State | FL
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