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

Omni Nutrition LLC

Organization Registered Dietitian · NPI 1104363605

Omni Nutrition LLC is a Registered Dietitian in New Smyrna Beach, Florida. Licensed in Florida. Registered with an NPI since 2017.

Licensed in
FL
In the registry since
2017
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

404 United Dr
New Smyrna Beach, FL 32168
Phone: (386) 968-2170
Fax: (386) 310-0587
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence ND6015 (FL)

Record details

NPI number1104363605
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lara Clevenger — Owner · (686) 968-2170
NPI enumeratedJanuary 23, 2017
Last updated in NPPESAugust 11, 2025
Mailing address3126 Tamarind Drive, Edgewater, FL 32141-6008

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