Provider Demographics
NPI:1588443469
Name:MIRHABIBI, NINA (CFNC, FNLP)
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:MIRHABIBI
Suffix:
Gender:F
Credentials:CFNC, FNLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8196 VIA VITTORIA WAY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-5429
Mailing Address - Country:US
Mailing Address - Phone:646-393-7500
Mailing Address - Fax:
Practice Address - Street 1:8196 VIA VITTORIA WAY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-5429
Practice Address - Country:US
Practice Address - Phone:646-393-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education