Provider Demographics
NPI:1427375476
Name:LONDON-SCHLANGER, BONNI ROSE (RD, LD/N)
Entity Type:Individual
Prefix:MRS
First Name:BONNI
Middle Name:ROSE
Last Name:LONDON-SCHLANGER
Suffix:
Gender:F
Credentials:RD, LD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 BAHIA VISTA ST
Mailing Address - Street 2:SUITE #102
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2635
Mailing Address - Country:US
Mailing Address - Phone:941-366-4422
Mailing Address - Fax:941-366-4420
Practice Address - Street 1:2650 BAHIA VISTA ST
Practice Address - Street 2:SUITE #102
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2635
Practice Address - Country:US
Practice Address - Phone:941-366-4422
Practice Address - Fax:941-366-4420
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-30
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17670133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered