MEDICARE: FRANCES DIANNE ASENCIO MS, RD, LDN, CNSC

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	133VN1101X	Gerontological Nutrition Registered Dietitian	846757	FL
2	133V00000X	Registered Dietitian	846757	FL

General Provider Information

NPI Number	:	1831732122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCES DIANNE ASENCIO MS, RD, LDN, CNSC

Provider Business Mailing Address
First Line	:	1919 VAN BUREN ST APT 121A
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-7812
Country	:	US
Telephone Number	:	973-474-0665
Fax Number	:

Provider Business Practice Location Address
First Line	:	1919 VAN BUREN ST APT 121A
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-7812
Country	:	US
Telephone Number	:	973-474-0665
Fax Number	:

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

Provider Enumeration Date	:	10/20/2019
Last Update Date	:	10/20/2019

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