Provider Demographics
NPI:1942502984
Name:SAMAKUR, SARALAKUMARI RAMADAS (RD/LDN)
Entity Type:Individual
Prefix:MRS
First Name:SARALAKUMARI
Middle Name:RAMADAS
Last Name:SAMAKUR
Suffix:
Gender:F
Credentials:RD/LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7025 NW 47TH TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32653-1153
Mailing Address - Country:US
Mailing Address - Phone:352-372-4438
Mailing Address - Fax:
Practice Address - Street 1:2409 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1305
Practice Address - Country:US
Practice Address - Phone:352-265-6890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-24
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND 2674133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered