|
| |
|
10570 S Us Highway 1 Ste 300, Port St Lucie, FL 34952-5606 | |
| (772) 878-8227 | |
| (772) 324-7863 |
| Full Name | |
|---|---|
| Type | Facility |
| Speciality | Dietitian, Registered |
| Location | 10570 S Us Highway 1 Ste 300, Port St Lucie, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760038939 | NPI | - | NPPES |
| 005491300 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
| Provider Name | Phara Taylor |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1740342799 PECOS PAC ID: 9638262090 Enrollment ID: I20120215000837 |
| Mailing Address | Practice Location Address |
|---|---|
402 Nw Lyndhurst Ct Fl 34983, Port Saint Lucie, FL 34983-3440 Ph: (772) 878-8227 | 10570 S Us Highway 1 Ste 300, Port St Lucie, FL 34952-5606 Ph: (772) 878-8227 |
Vanessa Loyd Sotomayor, RD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 172 Sw Glenwood Dr, Port St Lucie, FL 34984 Phone: 305-283-0851 | |
Julia Cairns-migone, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 10050 Sw Innovation Way, Suite 201, Port St Lucie, FL 34987 Phone: 772-879-8700 Fax: 772-879-8710 | |
Ms. Jodi B Newman, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2246 Sw Crocus Ln, Port St Lucie, FL 34953 Phone: 772-370-1522 | |
Dr. Lisa D Griffith, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 6709 Woods Island Cir, Apt 203, Port St Lucie, FL 34952 Phone: 909-213-3945 | |
Vanessa Dyer, RDN, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3048 Se Morningside Blvd, Port St Lucie, FL 34952 Phone: 561-316-0402 | |