NPIMap

Organization Active NPI

Dynamic Nutrition and Wellness, LLC

  • Registered Dietitian
  • Boca Raton, FL
National Provider Identifier
1437580008
Registry record updated Dec 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ND6066 Issued in FL
Legal business name
DYNAMIC NUTRITION AND WELLNESS, LLC
Practice address
1700 N Dixie Hwy
Ste 129
Boca Raton, FL 33432-1850
Phone
(954) 366-2490
NPI assigned
Dec 9, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2013

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

Authorized official

Name
Christina Wyatt
Title
Manager/Member
Phone
(954) 366-2490

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X ND6066 FL Primary

Addresses

Primary practice location

1700 N Dixie Hwy
Ste 129
Boca Raton, FL 33432-1850

Mailing address

1700 N Dixie Hwy
Ste 129
Boca Raton, FL 33432-1850

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1386547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386547200000",
    "number": "1437580008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 N DIXIE HWY",
            "address_2": "STE 129",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334321850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N DIXIE HWY",
            "address_2": "STE 129",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334321850",
            "telephone_number": "954-366-2490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC NUTRITION AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-09",
        "last_updated": "2013-12-09",
        "status": "A",
        "authorized_official_last_name": "WYATT",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "MANAGER/MEMBER",
        "authorized_official_telephone_number": "954-366-2490"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND6066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2013; 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.