Proactive Nutrition & Fitness, Inc

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

ND4570 Issued in FL

Legal business name

PROACTIVE NUTRITION & FITNESS, INC

Practice address

2106 SW 39TH Dr
Gainesville, FL 32607-4346

Phone

(352) 258-8220

NPI assigned

Jan 2, 2007

Organization subpart

No

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

Authorized official

Name

Tracy E Brown, R.D,L.D N

Title

Licensed Dietitian

Phone

(352) 258-8220

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790842383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 SW 39TH DR",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326074346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 SW 39TH DR",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326074346",
            "telephone_number": "352-258-8220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE NUTRITION & FITNESS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "LICENSED DIETITIAN",
        "authorized_official_telephone_number": "352-258-8220",
        "authorized_official_credential": "R.D,L.D N"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND4570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.