Organization
CSR NUTRITION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA S RAPHAEL RD, LD/N (OWNER/ SOLE PROPRIETOR)
(201) 844-0342
Entity
Organization
Contact information
Practice address
129 HARBOR LAKE CIR, GREENACRES, FL 33413-2125
(201) 844-0342
Mailing address
129 HARBOR LAKE CIR, GREENACRES, FL 33413-2125
(201) 844-0342
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
09/25/2020
Last updated
09/25/2020
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