MEDICARE: MEGHAN MORAN MS, RD, LD, CEDRD

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
1	133V00000X	Registered Dietitian	ND5323	FL

General Provider Information

NPI Number	:	1235580895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGHAN MORAN MS, RD, LD, CEDRD

Provider Business Mailing Address
First Line	:	812 W HARVARD ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-5204
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1411 EDGEWATER DR STE 203
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-6361
Country	:	US
Telephone Number	:	561-504-8573
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2016
Last Update Date	:	06/24/2016

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