Organization
SHAPES NUTRITION AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA ORTIZ RD,LN/D (REGISTERED DIETITIAN)
(305) 647-1985
Entity
Organization
Contact information
Practice address
923 41ST STREET, SUITE 102, MIAMI BEACH, FL 33140-2885
(305) 647-1985
Mailing address
4304 ALTON RD, APT 209, MIAMI BEACH, FL 33140
(786) 525-8929
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
954272
PR
Other
Enumeration date
09/10/2010
Last updated
09/22/2010
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