Provider Demographics
NPI:1336824184
Name:KATZ, JOHANNAH GIRON (RD)
Entity Type:Individual
Prefix:MRS
First Name:JOHANNAH
Middle Name:GIRON
Last Name:KATZ
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8168 VIA BELLA NOTTE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32836-7704
Mailing Address - Country:US
Mailing Address - Phone:407-489-4750
Mailing Address - Fax:
Practice Address - Street 1:7505 W SAND LAKE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-5109
Practice Address - Country:US
Practice Address - Phone:407-507-3837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12213133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered