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NPI Code Detail

MEDICARE: HAPPY TUMMY NUTRITION, LLC

MEDICARE: HAPPY TUMMY NUTRITION, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133VN1004XPediatric Nutrition Registered Dietitian

General Provider Information

NPI Number : 1164391579
Entity Type Code : Organization
Provider Name (Legal Business Name) : HAPPY TUMMY NUTRITION, LLC
Provider Business Mailing Address
First Line : PO BOX 130334
Second Line :
City : TAMPA
State : FL
Zip : 33681-0334
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 400 N TAMPA ST STE 1550
Second Line :
City : TAMPA
State : FL
Zip : 33602-4737
Country : US
Telephone Number : 813-590-7565
Fax Number :
Authorized Official
Title or Position : REGISTERED DIETITIAN & OWNER
Name : KRISTEN FUSTOS
Credential : MS, RDN, CSP, LD, CL
Telephone Number : 813-590-7565
Provider Enumeration Date : 11/03/2025
Last Update Date : 11/03/2025

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