Jeanette Poillucci, RD, LD/N

Primary specialty

Renal Nutrition Registered DietitianTaxonomy code 133VN1005X

License

ND4784 Issued in FL

Practice address

3700 NW 88TH Ave
102
Sunrise, FL 33351-6556

Phone

(954) 817-7508

NPI assigned

Jan 11, 2012

Last updated

Jan 11, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fay Nutrition

  • Registered Dietitian
  • San Francisco, CA
  • NPI 1104334465
  NPD (past)
• Nourish, Inc.

  • Registered Dietitian
  • Austin, TX
  • NPI 1558097824
  NPD (past)

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

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326240000000",
    "number": "1245500933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 NW 88TH AVE",
            "address_2": "102",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333516556",
            "telephone_number": "954-817-7508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 NW 88TH AVE",
            "address_2": "102",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333516556",
            "telephone_number": "954-817-7508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POILLUCCI",
        "first_name": "JEANETTE",
        "credential": "RD, LD/N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-11",
        "last_updated": "2012-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "FL",
            "license": "ND4784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daphne Marian Pitts, MD
• Linda Pledger
• PMC West Oakland Park LLC
• PMG Cardiology Inc
• Pods on Call
• Sandeep Pokhrial, PT
• Stephanie Polania, PA-C
• Beth Lynne Pomerantz Herzbrun, PH.D.
• Andres Ignacio Ponce Lairet
• Angelisa Farias Pontes

• Renal Nutrition Registered Dietitian in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Renal Nutrition Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; 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.