Provider Demographics
NPI:1700055324
Name:LANCHO, PAOLA IDA (RD, LD/N)
Entity Type:Individual
Prefix:MISS
First Name:PAOLA
Middle Name:IDA
Last Name:LANCHO
Suffix:
Gender:F
Credentials:RD, LD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:562 NW 82ND PL
Mailing Address - Street 2:APT 311
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3979
Mailing Address - Country:US
Mailing Address - Phone:305-607-8706
Mailing Address - Fax:
Practice Address - Street 1:562 NW 82ND PL
Practice Address - Street 2:APT 311
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-3979
Practice Address - Country:US
Practice Address - Phone:305-607-8706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND 4134133N00000X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist