Provider Demographics
NPI:1548394430
Name:LINDA FILENBAUM DIETICIAN NUTRITIONIST PA
Entity Type:Organization
Organization Name:LINDA FILENBAUM DIETICIAN NUTRITIONIST PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:MARLENE
Authorized Official - Last Name:FILENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:RD,LDN,CDE
Authorized Official - Phone:954-638-2961
Mailing Address - Street 1:7623 CINEBAR DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-6118
Mailing Address - Country:US
Mailing Address - Phone:954-638-2961
Mailing Address - Fax:
Practice Address - Street 1:7623 CINEBAR DR
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-6118
Practice Address - Country:US
Practice Address - Phone:954-638-2961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND 4674133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty