Active NPI
Liyao Fan, RD
- Registered Dietitian
- Miami Beach, FL
National Provider Identifier
1376316737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 086175875
- Practice address
- 7315 Carlyle Ave Apt 14
Miami Beach, FL 33141-2606 - Phone
- (312) 975-5852
- NPI assigned
- Nov 6, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | ND12583 | FL | |
| Registered Dietitian | 133V00000X | 086175875 | Primary |
Addresses
Primary practice location
7315 Carlyle Ave Apt 14
Miami Beach, FL 33141-2606
Mailing address
7315 Carlyle Ave Apt 14
Miami Beach, FL 33141-2606
Phone (312) 975-5852
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ND12583 | FL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1699228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699228800000",
"number": "1376316737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7315 CARLYLE AVE APT 14",
"city": "MIAMI BEACH",
"state": "FL",
"postal_code": "331412606",
"telephone_number": "312-975-5852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7315 CARLYLE AVE APT 14",
"city": "MIAMI BEACH",
"state": "FL",
"postal_code": "331412606",
"telephone_number": "312-975-5852"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAN",
"first_name": "LIYAO",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-06",
"last_updated": "2023-11-06",
"certification_date": "2023-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND12583",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": "086175875",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.