Organization
MIAMI DIETITIANS GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA EUGENIA RICCOMBENI RD LD N (AUTHORIZED OFFICIAL)
(786) 592-1520
Entity
Organization
Contact information
Practice address
11413 SW 246TH TER, HOMESTEAD, FL 33032-4655
(786) 592-1520
Mailing address
11413 SW 246TH TER, HOMESTEAD, FL 33032-4655
(786) 592-1520
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7293
ND7293
FL
Enumeration date
12/01/2020
Last updated
10/21/2021
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