Provider Demographics
NPI:1114616109
Name:RAFLOWITZ, TAYLOR (RD)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:RAFLOWITZ
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 NATIONS WAY
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-1822
Mailing Address - Country:US
Mailing Address - Phone:954-651-4527
Mailing Address - Fax:
Practice Address - Street 1:2020 NATIONS WAY
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-1822
Practice Address - Country:US
Practice Address - Phone:954-651-4527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND9308133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered