Provider Demographics
NPI:1255147492
Name:MCCARTHY, JAMIE RAY (RDN/LDN)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:RAY
Last Name:MCCARTHY
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 1:7048 CHESAPEAKE CIR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-8565
Mailing Address - Country:US
Mailing Address - Phone:561-634-1018
Mailing Address - Fax:
Practice Address - Street 1:7048 CHESAPEAKE CIR
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-8565
Practice Address - Country:US
Practice Address - Phone:561-634-1018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND4807133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered