MEDICARE: RNL WELLNESS, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	133VN1201X	Obesity and Weight Management Nutrition Registered Dietitian
2	163WN1003X	Nutrition Support Registered Nurse
3	207QB0002X	Obesity Medicine (Family Medicine) Physician
4	207RB0002X	Obesity Medicine (Internal Medicine) Physician
5	207VB0002X	Obesity Medicine (Obstetrics & Gynecology) Physician
6	2080B0002X	Pediatric Obesity Medicine Physician
7	2084B0002X	Obesity Medicine (Psychiatry & Neurology) Physician
8	363AM0700X	Medical Physician Assistant
9	363LP2300X	Primary Care Nurse Practitioner
10	2083B0002X	Obesity Medicine (Preventive Medicine) Physician

General Provider Information

NPI Number	:	1811643695
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RNL WELLNESS, LLC

Provider Business Mailing Address
First Line	:	15701 COCHESTER RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-1157
Country	:	US
Telephone Number	:	703-626-0548
Fax Number	:	240-238-7234

Provider Business Practice Location Address
First Line	:	11967 SHELDON RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33626-3644
Country	:	US
Telephone Number	:	703-626-0548
Fax Number	:	240-238-7234

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. RAMY MOHAMED ZAKI NASR
Credential	:	MD
Telephone Number	:	813-776-4400

Provider Enumeration Date	:	03/01/2022
Last Update Date	:	02/29/2024

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