Provider Demographics
NPI:1003004730
Name:GATES, HELEN BERINGER (MAG,RD,LD/N)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:BERINGER
Last Name:GATES
Suffix:
Gender:F
Credentials:MAG,RD,LD/N
Other - Prefix:
Other - First Name:HELEN
Other - Middle Name:MARIE
Other - Last Name:CINDRICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MAG,RD,LD/N
Mailing Address - Street 1:1290 GOLFVIEW AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33830-6703
Mailing Address - Country:US
Mailing Address - Phone:863-519-7900
Mailing Address - Fax:863-519-7696
Practice Address - Street 1:1255 BRICE BLVD
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830-6735
Practice Address - Country:US
Practice Address - Phone:863-519-8233
Practice Address - Fax:863-519-8304
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND 930133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU6043ZMedicare PIN