Provider Demographics
NPI:1598139586
Name:TARABEN, NOOR AESHEH (RD)
Entity Type:Individual
Prefix:MRS
First Name:NOOR
Middle Name:AESHEH
Last Name:TARABEN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 SE 3RD AVE
Mailing Address - Street 2:SUITE 415
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-2521
Mailing Address - Country:US
Mailing Address - Phone:954-713-3126
Mailing Address - Fax:954-358-4556
Practice Address - Street 1:1625 SE 3RD AVE
Practice Address - Street 2:SUITE 415
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-2521
Practice Address - Country:US
Practice Address - Phone:954-713-3126
Practice Address - Fax:954-358-4556
Is Sole Proprietor?:No
Enumeration Date:2015-11-14
Last Update Date:2015-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered