Provider Demographics
NPI:1508535238
Name:MARKLE, SARA (RD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:MARKLE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:BETSY
Other - Middle Name:
Other - Last Name:MARKLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD
Mailing Address - Street 1:125 ANONA PL
Mailing Address - Street 2:
Mailing Address - City:INDIAN HARBOUR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-4101
Mailing Address - Country:US
Mailing Address - Phone:805-252-3656
Mailing Address - Fax:321-549-6190
Practice Address - Street 1:125 ANONA PL
Practice Address - Street 2:
Practice Address - City:INDIAN HARBOUR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-4101
Practice Address - Country:US
Practice Address - Phone:805-252-3656
Practice Address - Fax:321-549-6190
Is Sole Proprietor?:No
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7859133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered