Provider Demographics
NPI:1912348335
Name:RD NUTRITION GROUP LLC
Entity type:Organization
Organization Name:RD NUTRITION GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ADRIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-448-9544
Mailing Address - Street 1:818 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-1846
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:941-567-6639
Practice Address - Street 1:818 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-1846
Practice Address - Country:US
Practice Address - Phone:786-343-5000
Practice Address - Fax:941-567-6639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-14
Last Update Date:2013-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND6527133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty