Provider Demographics
NPI:1225317357
Name:DAUER, CHRISTINA (MPH, RD, LDN, CDE)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:DAUER
Suffix:
Gender:F
Credentials:MPH, RD, LDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 MONDAVI PL
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-7123
Mailing Address - Country:US
Mailing Address - Phone:561-235-4570
Mailing Address - Fax:
Practice Address - Street 1:323 NW SPANISH RIVER BLVD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-4612
Practice Address - Country:US
Practice Address - Phone:561-235-4570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-07
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL003672133V00000X
FLND6066133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered