Provider Demographics
NPI: | 1407402027 |
---|---|
Name: | SFL NUTRITION LLC |
Entity type: | Organization |
Organization Name: | SFL NUTRITION LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CO-OWNER/RD |
Authorized Official - Prefix: | |
Authorized Official - First Name: | KENNETH |
Authorized Official - Middle Name: | LEO |
Authorized Official - Last Name: | SNYDER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 561-945-2926 |
Mailing Address - Street 1: | 1150 NW 72ND AVE STE 455 |
Mailing Address - Street 2: | |
Mailing Address - City: | MIAMI |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33126-1947 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 561-945-2926 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 2408 ASPEN WAY |
Practice Address - Street 2: | |
Practice Address - City: | BOYNTON BEACH |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33436-6612 |
Practice Address - Country: | US |
Practice Address - Phone: | 561-945-2926 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-08-11 |
Last Update Date: | 2023-08-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 133V00000X | Dietary & Nutritional Service Providers | Dietitian, Registered | Group - Multi-Specialty | |
No | 133N00000X | Dietary & Nutritional Service Providers | Nutritionist | Group - Multi-Specialty | |
No | 133NN1002X | Dietary & Nutritional Service Providers | Nutritionist | Nutrition, Education | Group - Multi-Specialty |
No | 133VN1004X | Dietary & Nutritional Service Providers | Dietitian, Registered | Nutrition, Pediatric | Group - Multi-Specialty |
No | 133VN1005X | Dietary & Nutritional Service Providers | Dietitian, Registered | Nutrition, Renal | Group - Multi-Specialty |
No | 133VN1006X | Dietary & Nutritional Service Providers | Dietitian, Registered | Nutrition, Metabolic | Group - Multi-Specialty |
No | 133VN1101X | Dietary & Nutritional Service Providers | Dietitian, Registered | Nutrition, Gerontological | Group - Multi-Specialty |
No | 133VN1201X | Dietary & Nutritional Service Providers | Dietitian, Registered | Nutrition, Obesity and Weight Management | Group - Multi-Specialty |
No | 133VN1301X | Dietary & Nutritional Service Providers | Dietitian, Registered | Nutrition, Oncology | Group - Multi-Specialty |
No | 133VN1401X | Dietary & Nutritional Service Providers | Dietitian, Registered | Nutrition, Pediatric Critical Care | Group - Multi-Specialty |
No | 133VN1501X | Dietary & Nutritional Service Providers | Dietitian, Registered | Nutrition, Sports Dietetics | Group - Multi-Specialty |