Provider Demographics
NPI:1598018095
Name:LIVINGSTON, SANDRA FINN (RD, LD/N)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:FINN
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:RD, LD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 VILLAGE SQUARE XING
Mailing Address - Street 2:SUITE 209
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4540
Mailing Address - Country:US
Mailing Address - Phone:561-371-5105
Mailing Address - Fax:
Practice Address - Street 1:800 VILLAGE SQUARE XING
Practice Address - Street 2:SUITE 209
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4540
Practice Address - Country:US
Practice Address - Phone:561-371-5105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-21
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND2360133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered