MEDICARE: MEGAN WISVARI LDN, RDN

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	:	1609750637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN WISVARI LDN, RDN

Provider Business Mailing Address
First Line	:	776 N ORANGE AVE APT 5221
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32801-7322
Country	:	US
Telephone Number	:	937-818-5181
Fax Number	:

Provider Business Practice Location Address
First Line	:	776 N ORANGE AVE APT 5221
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32801-7322
Country	:	US
Telephone Number	:	937-818-5181
Fax Number	:

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

Provider Enumeration Date	:	08/04/2025
Last Update Date	:	08/04/2025

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