Provider Demographics
NPI:1255480893
Name:HOWARD, LUANNE H (MS, RD, CDE, LDN)
Entity Type:Individual
Prefix:
First Name:LUANNE
Middle Name:H
Last Name:HOWARD
Suffix:
Gender:F
Credentials:MS, RD, CDE, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 MANATEE AVE W
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-4954
Mailing Address - Country:US
Mailing Address - Phone:941-747-9984
Mailing Address - Fax:941-794-0417
Practice Address - Street 1:2424 MANATEE AVE W
Practice Address - Street 2:SUITE 105
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-4954
Practice Address - Country:US
Practice Address - Phone:941-747-9984
Practice Address - Fax:941-794-0417
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND1008133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL811247900Medicaid
FL680226596Medicaid
FL811247900Medicaid