Provider Demographics
NPI:1417026006
Name:RZAD, KARON M (RD CDE)
Entity Type:Individual
Prefix:MRS
First Name:KARON
Middle Name:M
Last Name:RZAD
Suffix:
Gender:F
Credentials:RD CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 776
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33041-0776
Mailing Address - Country:US
Mailing Address - Phone:305-243-8885
Mailing Address - Fax:305-243-5233
Practice Address - Street 1:1475 NW 12TH AVE
Practice Address - Street 2:C035
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1002
Practice Address - Country:US
Practice Address - Phone:305-243-8885
Practice Address - Fax:305-243-5233
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND 2445133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic