PUREVITAL NUTRITION LLC
NPI 1285598102
Dietitian, Registered in Jacksonville, FL

Q: What is Purevital Nutrition LLC's NPI number?

The NPI number for Purevital Nutrition LLC is 1285598102. It was assigned to this organization in the NPPES registry on December 15, 2025.

Q: What is Purevital Nutrition LLC's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Active since December 15, 2025

10752 DEERWOOD PARK BLVD STE 100, JACKSONVILLE, FL 32256(904) 763-9722(904) 833-3377 Get Directions Write a Review

NPPES record last updated: December 15, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Purevital Nutrition Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PUREVITAL NUTRITION LLC (NPI 1285598102) is a healthcare organization registered as a dietitian, registered in Jacksonville, Florida and active in the NPI registry since December 2025. The organization lists Mercedes Waugaman, Owner, as its authorized official.

NPPES Registry Identity

NPI1285598102

Entity TypeOrganization

Primary Taxonomy133V00000X

Legal Business NamePUREVITAL NUTRITION LLC

Location Address10752 DEERWOOD PARK BLVD STE 100Jacksonville, FL 32256-4846

Mailing Address5274 Legacy Pines WayJacksonville, FL 32224-4410 · (904) 763-9722 · Fax (904) 833-3377

Phone(904) 763-9722

Fax(904) 833-3377

Organization SubpartNo

Authorized OfficialMercedes WaugamanOwner · (904) 763-9722

Enumeration DateDecember 15, 2025

NPPES CertifiedDecember 15, 2025

✔ NPI 1285598102 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers

Taxonomy Code133V00000X

Definition

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

10752 DEERWOOD PARK BLVD STE 100, Jacksonville, FL 32256

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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