Provider Demographics
NPI:1184595605
Name:LUDERT, CAMILA (RDN, LDN)
Entity type:Individual
Prefix:
First Name:CAMILA
Middle Name:
Last Name:LUDERT
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10710 NW 66TH ST
Mailing Address - Street 2:APARTMENT 303
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178
Mailing Address - Country:US
Mailing Address - Phone:954-842-9177
Mailing Address - Fax:
Practice Address - Street 1:10710 NW 66TH STREET
Practice Address - Street 2:APARTMENT 303
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178
Practice Address - Country:US
Practice Address - Phone:954-842-9177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND12575133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered