Provider Demographics
NPI:1356575765
Name:SEGARRA, MAGDALINE FRANCES (RD, LD/N)
Entity type:Individual
Prefix:MRS
First Name:MAGDALINE
Middle Name:FRANCES
Last Name:SEGARRA
Suffix:
Gender:F
Credentials:RD, LD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19151 NW 23RD CT
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-5336
Mailing Address - Country:US
Mailing Address - Phone:954-441-4235
Mailing Address - Fax:954-441-4235
Practice Address - Street 1:19151 NW 23RD CT
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-5336
Practice Address - Country:US
Practice Address - Phone:954-441-4235
Practice Address - Fax:954-441-4235
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND2325133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered