Provider Demographics
NPI:1427934744
Name:4 HEALTH NUTS FL LLC
Entity type:Organization
Organization Name:4 HEALTH NUTS FL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-579-5441
Mailing Address - Street 1:500 POST RD E FL 2
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-4431
Mailing Address - Country:US
Mailing Address - Phone:917-579-5441
Mailing Address - Fax:646-514-7520
Practice Address - Street 1:901 INDUSTRIAL DR STE 2195
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:FL
Practice Address - Zip Code:34785-4707
Practice Address - Country:US
Practice Address - Phone:917-579-5441
Practice Address - Fax:646-514-7520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care