Provider Demographics
NPI:1902141187
Name:DELITEFULLY NUTRITIOUS INC
Entity Type:Organization
Organization Name:DELITEFULLY NUTRITIOUS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BELA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAUBER
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:954-629-9604
Mailing Address - Street 1:365 SW 17TH ST
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-7237
Mailing Address - Country:US
Mailing Address - Phone:561-367-4008
Mailing Address - Fax:561-367-4008
Practice Address - Street 1:365 SW 17TH ST
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-7237
Practice Address - Country:US
Practice Address - Phone:561-367-4008
Practice Address - Fax:561-367-4008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-29
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty