MEDICARE: FOOD CENTERED SOLUTIONS

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	133N00000X	Nutritionist	7102	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	86029715	OTHER		ACADEMY OF NUTRITION AND DIETETICS

General Provider Information

NPI Number	:	1669954137
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOOD CENTERED SOLUTIONS

Provider Business Mailing Address
First Line	:	829 E DOTY BRANCH LN
Second Line	:
City	:	SAINT JOHNS
State	:	FL
Zip	:	32259-5474
Country	:	US
Telephone Number	:	904-562-0082
Fax Number	:

Provider Business Practice Location Address
First Line	:	504 OSCEOLA AVE
Second Line	:
City	:	JAX BCH
State	:	FL
Zip	:	32250
Country	:	US
Telephone Number	:	904-562-0082
Fax Number	:

Authorized Official
Title or Position	:	REGISTERED DIETITIAN NUTRITIONIST
Name	:	FRANCES CATHERINE SIVER
Credential	:	MS, RDN, LDN, IFNCP
Telephone Number	:	904-562-0082

Provider Enumeration Date	:	08/31/2018
Last Update Date	:	09/05/2018

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