Provider Demographics
NPI:1306391586
Name:MADURO, NAZIRBER D (RDN, CDN, CDCES)
Entity Type:Individual
Prefix:MS
First Name:NAZIRBER
Middle Name:D
Last Name:MADURO
Suffix:
Gender:F
Credentials:RDN, CDN, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11835 QUEENS BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-7211
Mailing Address - Country:US
Mailing Address - Phone:929-307-0050
Mailing Address - Fax:
Practice Address - Street 1:601 BRICKELL KEY DR STE 700
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-2649
Practice Address - Country:US
Practice Address - Phone:929-307-0050
Practice Address - Fax:888-494-2097
Is Sole Proprietor?:No
Enumeration Date:2016-08-17
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86033559133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered