Provider Demographics
NPI:1588480131
Name:LAFUENTE, AMEE LIZ (MS, RD)
Entity type:Individual
Prefix:
First Name:AMEE
Middle Name:LIZ
Last Name:LAFUENTE
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 S 17TH ST APT 469
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-6580
Mailing Address - Country:US
Mailing Address - Phone:787-365-7335
Mailing Address - Fax:
Practice Address - Street 1:1625 S 17TH ST APT 469
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-6580
Practice Address - Country:US
Practice Address - Phone:787-365-7335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC86077477133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered