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Organization

EN LA MESA NUTRITION LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DIANA MESA RDN, LDN, CDCES (OWNER)
(786) 218-4310
Entity
Organization

Contact information

Practice address
1120 SE MADISON ST, PORTLAND, OR 97214-3618
(786) 600-7586
(786) 954-1856
Mailing address
810 NE 149TH ST, NORTH MIAMI, FL 33161-2349
(786) 218-4310

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary

Other

Enumeration date
06/27/2024
Last updated
06/27/2024
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