Provider Demographics
NPI:1356105563
Name:PRATT, SERENA (RD)
Entity type:Individual
Prefix:
First Name:SERENA
Middle Name:
Last Name:PRATT
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 1:7832 FREESTYLE LN
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-0083
Mailing Address - Country:US
Mailing Address - Phone:914-629-3183
Mailing Address - Fax:
Practice Address - Street 1:7832 FREESTYLE LN
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-0083
Practice Address - Country:US
Practice Address - Phone:914-629-3183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered