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General NPI Number Information
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NPI Number | 1710865043
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Entity Type | Individual
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Provider Name | JANNELL ELAINE BAEZ RD, LD/N
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Gender |
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 1930 HARRISON ST STE 404
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City | HOLLYWOOD
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State | FL
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Zip | 33020-7829
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Country | US
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Telephone | 786-780-1188
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Fax |
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Provider Business Mailing Address
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Address Line | 5731 SW 111 TERR
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City | COOPER CITY
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State | FL
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Zip | 33328-6306
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Country | US
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Telephone | 305-310-7554
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | ND4237
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License Number State | FL
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