| Longevity Functional Wellness | |
|
500 Canal Rd, Ponte Vedra Beach, FL 32082-4300 | |
| (904) 535-6901 | |
| Not Available |
| Full Name | Longevity Functional Wellness |
|---|---|
| Type | Facility |
| Speciality | Dietitian, Registered |
| Location | 500 Canal Rd, Ponte Vedra Beach, Florida |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629725312 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | (NU) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Longevity Functional Wellness 500 Canal Rd, Ponte Vedra Beach, FL 32082-4300 Ph: (904) 535-6901 | Longevity Functional Wellness 500 Canal Rd, Ponte Vedra Beach, FL 32082-4300 Ph: (904) 535-6901 |
Greenlyfe Nutrition, Llc Dietitian Medicare: Not Enrolled in Medicare Practice Location: 312 Osprey Nest Ct, Ponte Vedra Beach, FL 32082 Phone: 508-963-8537 |
Laura Vazzo Mcdevitt, M.ED.,R.D.,LD/N Dietitian Medicare: Not Enrolled in Medicare Practice Location: 428 Clearwater Dr, Ponte Vedra Beach, FL 32082 Phone: 904-469-1717 |
Tracey O'neill, CNS, LDN Dietitian Medicare: Medicare Enrolled Practice Location: 500 Canal Rd, Ponte Vedra Beach, FL 32082 Phone: 904-535-6901 |
Carolyn Irene Dewane, RD,LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 253 Seamist Ct, Ponte Vedra Beach, FL 32082 Phone: 904-610-1640 |
Blaire Murphy, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 705 Boardwalk Dr Unit 434, Ponte Vedra Beach, FL 32082 Phone: 904-806-8553 |
Melissa Gopp-warner, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 113 Solano Woods Dr, Ponte Vedra Beach, FL 32082 Phone: 240-898-5127 |
Shoba Balaji, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 312 Osprey Nest Ct, Ponte Vedra Beach, FL 32082 Phone: 508-963-8537 |