Provider Demographics
NPI:1467758995
Name:PRZYTULSKI, KAREN (RD)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:PRZYTULSKI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:RUTHERFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:25275 RAMPART BLVD
Mailing Address - Street 2:1307
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33983-6440
Mailing Address - Country:US
Mailing Address - Phone:517-945-4706
Mailing Address - Fax:
Practice Address - Street 1:4161 TAMIAMI TRL
Practice Address - Street 2:SUITE 401
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-9204
Practice Address - Country:US
Practice Address - Phone:941-235-2710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-01
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND5533133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
380493OtherAMERICAN DIETETIC ASSOCIATION