Provider Demographics
NPI:1427027432
Name:DIMARCO, CYNTHIA C (RD LD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:C
Last Name:DIMARCO
Suffix:
Gender:F
Credentials:RD LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3938 PINEHURST DR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-2944
Mailing Address - Country:US
Mailing Address - Phone:561-641-4900
Mailing Address - Fax:561-641-0136
Practice Address - Street 1:3938 PINEHURST DR
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2944
Practice Address - Country:US
Practice Address - Phone:561-641-4900
Practice Address - Fax:561-641-0136
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND0001538133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE8159ZMedicare ID - Type Unspecified