Individual
BROOKE FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ND
Contact information
Practice address
1211 CENTRAL PKWY, DELAND, FL 32724-3372
(352) 978-8507
Mailing address
1211 CENTRAL PKWY, DELAND, FL 32724-3372
(352) 978-8507
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
132700000X
Dietary Manager
—
—
133N00000X
Nutritionist
—
—
175F00000X
Naturopath
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12834006
CASH
—
Enumeration date
05/12/2021
Last updated
05/04/2023
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