Provider Demographics
NPI:1760866958
Name:RASHID, KELLY KUGLER (RDN)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:KUGLER
Last Name:RASHID
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:
Other - Last Name:KUGLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:4725 N FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4603
Mailing Address - Country:US
Mailing Address - Phone:954-771-8000
Mailing Address - Fax:
Practice Address - Street 1:3070 NE 43RD ST
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-5806
Practice Address - Country:US
Practice Address - Phone:610-310-9581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-17
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND7374133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered