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Contact Information

OMNI NUTRITION LLC
404 UNITED DRIVE
NEW SMYRNA BEACH, FL32168
 Phone: 386-968-2170
 Fax: 386-310-0587
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dietitian, Registered

133V00000X 71 Registered Dietitian or Nutrition Professional
Indicates primary specialty

NPI Profile & details for OMNI NUTRITION LLC · (Female)

NPI # 1104363605
Status Active
Credentials
Entity Individual
Enumeration date 01/23/2017
Last updated 08/11/2025 - About 10 months ago
Sole proprietor 1 Not specified
Identifiers
  • FL License # ND6015
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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