Organization Active NPI

Your Dietitian for Life LLC

  • Registered Dietitian
  • Davie, FL
National Provider Identifier
1104400183
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
YOUR DIETITIAN FOR LIFE LLC
Practice address
15901 Surrey Cir
Davie, FL 33331-2571
Phone
(954) 850-2926
NPI assigned
May 6, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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

Authorized official

Name
Cara Axelrod, RDNPI 1750870341
Title
Owner
Phone
(954) 850-2926

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

15901 Surrey Cir
Davie, FL 33331-2571

Mailing address

15901 Surrey Cir
Davie, FL 33331-2571
Phone (954) 850-2926

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1620259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620259200000",
    "number": "1104400183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15901 SURREY CIR",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333312571",
            "telephone_number": "954-850-2926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15901 SURREY CIR",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333312571",
            "telephone_number": "954-850-2926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR DIETITIAN FOR LIFE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-06",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A",
        "authorized_official_last_name": "AXELROD",
        "authorized_official_first_name": "CARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-850-2926",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.