Provider Demographics
NPI:1639495450
Name:KAROUSATOS, REBECCA C (MS RD LDN)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:C
Last Name:KAROUSATOS
Suffix:
Gender:F
Credentials:MS RD LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7500 SW 87 AVENUE
Mailing Address - Street 2:SUITE200
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173
Mailing Address - Country:US
Mailing Address - Phone:305-913-0666
Mailing Address - Fax:305-913-0663
Practice Address - Street 1:7500 SW 87TH AVE
Practice Address - Street 2:SUITE200
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5426
Practice Address - Country:US
Practice Address - Phone:305-913-0666
Practice Address - Fax:305-913-0663
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-19
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLND1900133VN1006X
GALD005549133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic