Active NPI
Your Dietitian for Life LLC
- Registered Dietitian
- Davie, FL
National Provider Identifier
1104400183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Cara Axelrod, RD
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 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 DirectoryPractitioners & 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.