Organization
NUTRITION OF EVE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LACIE L BRISBON (CERTIFIED HOLISTIC NUTRITIONIST CEO)
(407) 455-8258
Entity
Organization
Contact information
Practice address
13166 ODYSSEY LAKE WAY, ORLANDO, FL 32826-4642
(407) 455-8258
Mailing address
13166 ODYSSEY LAKE WAY, ORLANDO, FL 32826-4642
(407) 455-8258
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1982292173
NUTRITION AND WELLNESS
FL
Enumeration date
03/26/2021
Last updated
03/26/2021
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