Provider Demographics
NPI:1992954036
Name:NUTRITION COACH INC
Entity type:Organization
Organization Name:NUTRITION COACH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:KORITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS RD LDN
Authorized Official - Phone:561-289-7215
Mailing Address - Street 1:100 E LINTON BLVD
Mailing Address - Street 2:SUITE 304B
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-3327
Mailing Address - Country:US
Mailing Address - Phone:561-289-7215
Mailing Address - Fax:561-210-1374
Practice Address - Street 1:100 E LINTON BLVD
Practice Address - Street 2:SUITE 304B
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-3327
Practice Address - Country:US
Practice Address - Phone:561-289-7215
Practice Address - Fax:561-210-1374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-13
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND5063261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1699945386OtherBLUE CROSS BLUE SHIELD
FL1699945386OtherAMERICAN SPECIALTY HEALTH
FL1699945386OtherUNITED HEALTH