Provider Demographics
NPI:1679339360
Name:BAUMBERGER, SABRINA (RD, LD)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:BAUMBERGER
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5499 OAK CREST BLVD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-3298
Mailing Address - Country:US
Mailing Address - Phone:312-497-5715
Mailing Address - Fax:
Practice Address - Street 1:101 RIVERFRONT BLVD STE 700
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-8823
Practice Address - Country:US
Practice Address - Phone:941-748-2417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND7498133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered