Provider Demographics
NPI:1669762514
Name:GOLAN, LIAT (RD,LD/N)
Entity type:Individual
Prefix:MRS
First Name:LIAT
Middle Name:
Last Name:GOLAN
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 1:476 BELMIST CT
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-7302
Mailing Address - Country:US
Mailing Address - Phone:727-735-4473
Mailing Address - Fax:727-216-6735
Practice Address - Street 1:476 BELMIST CT
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-7302
Practice Address - Country:US
Practice Address - Phone:727-735-4473
Practice Address - Fax:727-216-6735
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND 5321133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered