Flavorful Nutrition LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

ND4691 Issued in FL

Legal business name

FLAVORFUL NUTRITION LLC

Practice address

5200 NE 3Rd Ter
Oakland Park, FL 33334-2404

Phone

(954) 682-3526

NPI assigned

May 7, 2015

Organization subpart

No

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

Authorized official

Name

Stacy Roberts Davis, RD

Title

President

Phone

(954) 682-3526

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1430956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721865600000",
    "number": "1487032629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8282 SW 1ST MNR",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330717500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 NE 3RD TER",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333342404",
            "telephone_number": "954-682-3526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLAVORFUL NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-07",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A",
        "authorized_official_last_name": "ROBERTS DAVIS",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-682-3526",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND4691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.