Provider Demographics
NPI:1659537900
Name:SHERES, SUZANNE ZEICHNER (RD)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:ZEICHNER
Last Name:SHERES
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:
Other - Last Name:ZEICHNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2900 CORPORATE WAY
Mailing Address - Street 2:DOOR D
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3925
Mailing Address - Country:US
Mailing Address - Phone:954-276-5685
Mailing Address - Fax:954-985-7074
Practice Address - Street 1:3377 S STATE ROAD 7 STE 100
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33449-8002
Practice Address - Country:US
Practice Address - Phone:561-341-7000
Practice Address - Fax:561-784-7098
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND413133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric