Provider Demographics
NPI:1043957053
Name:FRANCO, EVIJOHN JESSE (MS, RDN, LD/N)
Entity type:Individual
Prefix:MR
First Name:EVIJOHN
Middle Name:JESSE
Last Name:FRANCO
Suffix:
Gender:M
Credentials:MS, RDN, LD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 LAKESHORE DR APT 320
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-6621
Mailing Address - Country:US
Mailing Address - Phone:786-624-9396
Mailing Address - Fax:
Practice Address - Street 1:5800 LAKESHORE DR APT 320
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-6621
Practice Address - Country:US
Practice Address - Phone:786-624-9396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-19
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND10003133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered