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General NPI Number Information
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NPI Number | 1912348335
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Entity Type | Organization
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Legal Business Name | RD NUTRITION GROUP LLC
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Dates
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Enumeration Date | 07/14/2013
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Last Update Date | 07/14/2013
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Provider Practice Location Address
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Address Line | 818 HILLCREST DR
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City | BRADENTON
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State | FL
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Zip | 34209-1846
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Country | US
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Telephone | 786-343-5000
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Fax | 941-567-6639
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Provider Business Mailing Address
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Address Line | 818 HILLCREST DR
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City | BRADENTON
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State | FL
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Zip | 34209-1846
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Country | US
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Telephone |
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Fax | 941-567-6639
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. BEN ADRIAN
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Credential |
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Telephone | 941-448-9544
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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 | ND6527
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License Number State | FL
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