MEDICARE: COST EFFECTIVE ENTERPRISES, 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
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1255997342
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COST EFFECTIVE ENTERPRISES, LLC

Provider Business Mailing Address
First Line	:	5049 N HWY A1A APT 304
Second Line	:
City	:	HUTCHINSON ISLAND
State	:	FL
Zip	:	34949-8287
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5049 N HWY A1A APT 304
Second Line	:
City	:	HUTCHINSON ISLAND
State	:	FL
Zip	:	34949-8287
Country	:	US
Telephone Number	:	772-242-3570
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ALICIA ANNE COST
Credential	:	RD
Telephone Number	:	772-242-3570

Provider Enumeration Date	:	05/14/2019
Last Update Date	:	07/02/2019

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