Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Coralcrestnutrition LLC

Organization Registered Dietitian · NPI 1407793359

Coralcrestnutrition LLC is a Registered Dietitian in Gulf Breeze, Florida. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6297 Jenks Dr
Gulf Breeze, FL 32563-9798
Phone: (850) 339-0728
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X

Record details

NPI number1407793359
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Evetha Malcolm-Theriault — Registered Dietitian · (850) 339-0728
NPI enumeratedApril 29, 2026
Last updated in NPPESApril 29, 2026
Certification dateApril 29, 2026
Mailing address3311 Gulf Breeze Pkwy # 110, Gulf Breeze, FL 32563-3351

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