Provider Demographics
NPI:1366634867
Name:BERMUDEZ, DEBRA STRONG (RD)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:STRONG
Last Name:BERMUDEZ
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:CLAIRE
Other - Last Name:STRONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 55309
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-5309
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2005 VETERANS MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-6320
Practice Address - Country:US
Practice Address - Phone:504-836-9820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1764133V00000X
LA1742133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051542981OtherBCBS
AL051542982OtherBCBS
LA3A9567061Medicare PIN
AL051542981OtherBCBS