| NPI | 1306334578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERI BOMARITO Owner 904-540-2503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: FL 86032198) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: FL ND7315) |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2018-04-24 |