Lifebalance Nutrition LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

LIFEBALANCE NUTRITION LLC

Practice address

1930 Estuary LN
Kissimmee, FL 34747-2820

Phone

(724) 678-9544

Fax

(267) 695-5612

NPI assigned

Mar 18, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Camilia Younes, MS, RDN, LDN, CDCES

Title

Registered Dietitian

Phone

(724) 678-9544

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628640000000",
    "number": "1003375080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 ESTUARY LN",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347472820",
            "telephone_number": "724-678-9544",
            "fax_number": "267-695-5612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 ESTUARY LN",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347472820",
            "telephone_number": "724-678-9544",
            "fax_number": "267-695-5612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBALANCE NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-18",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A",
        "authorized_official_last_name": "YOUNES",
        "authorized_official_first_name": "CAMILIA",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "724-678-9544",
        "authorized_official_credential": "MS, RDN, LDN, CDCES"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.