Provider Demographics
NPI:1619321841
Name:NELSON, SHERI (RD/LDN)
Entity Type:Individual
Prefix:MRS
First Name:SHERI
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:RD/LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:791 NW 104TH AVE
Mailing Address - Street 2:UNIT 203
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-5990
Mailing Address - Country:US
Mailing Address - Phone:305-801-8713
Mailing Address - Fax:
Practice Address - Street 1:951 NE 167TH ST
Practice Address - Street 2:STE 102
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-3711
Practice Address - Country:US
Practice Address - Phone:786-565-9486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-13
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND5348133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered