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General NPI Number Information
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NPI Number | 1578423083
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Entity Type | Organization
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Legal Business Name | NEW LIFE NUTRITION & WELLNESS LLC
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Dates
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Enumeration Date | 11/17/2025
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Last Update Date | 11/17/2025
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Provider Practice Location Address
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Address Line | 209 1/2 12TH AVE N
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City | ST PETERSBURG
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State | FL
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Zip | 33701-1737
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Country | US
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Telephone | 727-258-1906
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Fax | 727-258-3151
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Provider Business Mailing Address
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Address Line | 209 1/2 12TH AVE N
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City | ST PETERSBURG
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State | FL
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Zip | 33701-1737
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Country | US
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Telephone | 727-258-1906
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Fax | 727-258-3151
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Authorized Official
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Title or Position | REGISTERED DIETITIAN
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Name | YOKO L YOUNGMAN
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Credential | RD, LDN
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Telephone | 727-258-1906
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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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