Provider Demographics
NPI:1407031842
Name:AMAR, LEAH (RD)
Entity Type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:
Last Name:AMAR
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4721 SARAZEN DR
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-2345
Mailing Address - Country:US
Mailing Address - Phone:954-966-7439
Mailing Address - Fax:
Practice Address - Street 1:4721 SARAZEN DR
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-2345
Practice Address - Country:US
Practice Address - Phone:954-966-7439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-03
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
871532OtherR.D. REGISTRATION