Provider Demographics
NPI:1528578226
Name:PAZOS MALATESTA, LAURA (RDN)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:PAZOS MALATESTA
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 QUAYSIDE TER APT 308
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33138-2216
Mailing Address - Country:US
Mailing Address - Phone:305-439-0476
Mailing Address - Fax:
Practice Address - Street 1:1000 QUAYSIDE TER APT 308
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33138-2216
Practice Address - Country:US
Practice Address - Phone:305-439-0476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-07
Last Update Date:2017-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND8151133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered