Provider Demographics
NPI:1760207310
Name:JOAN Z CORNIER LLC
Entity type:Organization
Organization Name:JOAN Z CORNIER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:Z
Authorized Official - Last Name:CORNIER
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LD, CDCES
Authorized Official - Phone:321-287-1842
Mailing Address - Street 1:202 SQUIRREL TRL
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-3412
Mailing Address - Country:US
Mailing Address - Phone:321-287-1842
Mailing Address - Fax:
Practice Address - Street 1:202 SQUIRREL TRL
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-3412
Practice Address - Country:US
Practice Address - Phone:321-287-1842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight ManagementGroup - Multi-Specialty
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, MetabolicGroup - Multi-Specialty