Provider Demographics
NPI:1770464653
Name:VARGAS ARRIETA, LAURA MARCELA (RD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:MARCELA
Last Name:VARGAS ARRIETA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 SE 32ND AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-7153
Mailing Address - Country:US
Mailing Address - Phone:305-562-0121
Mailing Address - Fax:
Practice Address - Street 1:256 SE 32ND AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-7153
Practice Address - Country:US
Practice Address - Phone:305-562-0121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14464133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty