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General NPI Number Information
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NPI Number | 1760207310
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Entity Type | Organization
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Legal Business Name | JOAN Z CORNIER LLC
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Dates
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Enumeration Date | 11/19/2024
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 202 SQUIRREL TRL
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City | LONGWOOD
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State | FL
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Zip | 32779-3412
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Country | US
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Telephone | 321-287-1842
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Fax |
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Provider Business Mailing Address
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Address Line | 202 SQUIRREL TRL
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City | LONGWOOD
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State | FL
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Zip | 32779-3412
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Country | US
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Telephone | 321-287-1842
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Fax |
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Authorized Official
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Title or Position | REGISTERED DIETITIAN
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Name | MRS. JOAN Z CORNIER
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Credential | RD, LD, CDCES
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Telephone | 321-287-1842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1201X
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Taxonomy Name | Obesity and Weight Management Nutrition Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133VN1006X
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Taxonomy Name | Metabolic Nutrition Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #3
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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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