Mary Michelle Urena, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

6101-69918 Issued in FL

Practice address

3402 N 22ND St
Tampa, FL 33605-1214

Phone

(347) 858-3258

NPI assigned

Jun 13, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mary Michelle Hiciano Former name

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 and National Provider Directory roles.

• Nourish, Inc.

  • Registered Dietitian
  • Austin, TX
  • NPI 1558097824

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1686614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1881378503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8524 EDGEWATER PLACE BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336151390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3402 N 22ND ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336051214",
            "telephone_number": "347-858-3258"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8524 Edgewater Place Blvd",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336151390",
            "country_code": "US",
            "telephone_number": "347-858-3258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "URENA",
        "first_name": "MARY MICHELLE",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-13",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "FL",
            "license": "6101-69918",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "6101-69918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY MICHELLE",
            "last_name": "HICIANO",
            "credential": "RDN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lindsey Urban
• Megan Urbano
• Ilyne Kobrin Urbanovich, D.C.
• Anthony Eugene Urbisci, M.D.
• Arnel Urbiztondo
• Urgent Care Express
• Urgent Health Centers Inc.
• Urgicare Tampa, LLC
• Urgimed West LLC
• Joseph Anthony Uriarte

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.

Verify at the official NPI Registry.