Individual provider Active NPI

Stephanie Tazi-Sidqui

  • Nutritionist
  • Miami, FL
National Provider Identifier
1104384890
Registry record updated Mar 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
ND4008 Issued in FL
Practice address
9740 SW 40TH St
Miami, FL 33165-4080
Phone
(305) 662-5200
NPI assigned
Mar 12, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X ND4008 FL Primary

Addresses

Primary practice location

9740 SW 40TH St
Miami, FL 33165-4080

Mailing address

9740 SW 40TH St
Miami, FL 33165-4080
Phone (305) 662-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1552348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1104384890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9740 SW 40TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331654080",
            "telephone_number": "305-662-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9740 SW 40TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331654080",
            "telephone_number": "305-662-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAZI-SIDQUI",
        "first_name": "STEPHANIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-12",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "FL",
            "license": "ND4008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; 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.