Provider Demographics
NPI:1144377524
Name:REARDON, ELIZABETH ZARCONE (MS, RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ZARCONE
Last Name:REARDON
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 SE 14TH TER
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-4516
Mailing Address - Country:US
Mailing Address - Phone:351-402-5255
Mailing Address - Fax:352-402-5157
Practice Address - Street 1:1500 SW 1ST AVE
Practice Address - Street 2:MUNROE REGIONAL MEDICAL CENTER
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-4004
Practice Address - Country:US
Practice Address - Phone:352-402-5255
Practice Address - Fax:352-402-5257
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND2543133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered