Provider Demographics
NPI:1104229087
Name:EAT RIGHT LIVE LONGER
Entity type:Organization
Organization Name:EAT RIGHT LIVE LONGER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NEDA
Authorized Official - Middle Name:
Authorized Official - Last Name:RABETI
Authorized Official - Suffix:
Authorized Official - Credentials:RD,LD/N
Authorized Official - Phone:954-774-5115
Mailing Address - Street 1:2441 SW 82ND AVE APT 105
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33324-5730
Mailing Address - Country:US
Mailing Address - Phone:954-774-5115
Mailing Address - Fax:
Practice Address - Street 1:2441 SW 82ND AVE APT 105
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33324-5730
Practice Address - Country:US
Practice Address - Phone:954-774-5115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-06
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND6022133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty