Provider Demographics
NPI:1902515521
Name:VIDA EATS, LLC
Entity Type:Organization
Organization Name:VIDA EATS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENITO
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:860-944-0232
Mailing Address - Street 1:699 16TH AVE S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-5407
Mailing Address - Country:US
Mailing Address - Phone:860-944-0232
Mailing Address - Fax:
Practice Address - Street 1:699 16TH AVE S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-5407
Practice Address - Country:US
Practice Address - Phone:860-944-0232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-22
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, RenalGroup - Multi-Specialty