Provider Demographics
NPI:1467601179
Name:KRAMER, MARLENE DIXIE (RD)
Entity Type:Individual
Prefix:MS
First Name:MARLENE
Middle Name:DIXIE
Last Name:KRAMER
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 1:214 S PINE AVE
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34452-4838
Mailing Address - Country:US
Mailing Address - Phone:407-467-8463
Mailing Address - Fax:
Practice Address - Street 1:214 S PINE AVE
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34452-4838
Practice Address - Country:US
Practice Address - Phone:407-467-8463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-17
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND77133V00000X
FL436647133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered