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General NPI Number Information
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NPI Number | 1386101830
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Entity Type | Organization
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Legal Business Name | CASSANDRA SUAREZ NUTRITION LLC
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Dates
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Enumeration Date | 02/20/2019
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Last Update Date | 02/20/2019
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Provider Practice Location Address
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Address Line | 4904 ROSENA DR
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City | CHARLOTTE
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State | NC
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Zip | 28227-3007
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Country | US
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Telephone | 651-243-2584
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Fax |
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Provider Business Mailing Address
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Address Line | 4904 ROSENA DR
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City | CHARLOTTE
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State | NC
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Zip | 28227-3007
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | REGISTERED DIETITIAN/OWNER
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Name | CASSANDRA ANNE SUAREZ
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Credential | MS, RDN, LDN, CPT
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Telephone | 978-376-0458
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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