Provider Demographics
NPI:1275193500
Name:ABED, BERLINDA
Entity Type:Individual
Prefix:
First Name:BERLINDA
Middle Name:
Last Name:ABED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 DRIFTWOOD CT
Mailing Address - Street 2:
Mailing Address - City:MARCO ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:34145-4528
Mailing Address - Country:US
Mailing Address - Phone:239-272-2088
Mailing Address - Fax:
Practice Address - Street 1:101 SAND HILL ST
Practice Address - Street 2:
Practice Address - City:MARCO ISLAND
Practice Address - State:FL
Practice Address - Zip Code:34145-4614
Practice Address - Country:US
Practice Address - Phone:239-970-8293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND7385133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered