Provider Demographics
NPI:1811240757
Name:YEAMANS, DEENA (RDN)
Entity type:Individual
Prefix:
First Name:DEENA
Middle Name:
Last Name:YEAMANS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7440 SAN CLEMENTE PL
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-1005
Mailing Address - Country:US
Mailing Address - Phone:786-763-0041
Mailing Address - Fax:
Practice Address - Street 1:21301 POWERLINE RD STE 107
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-2389
Practice Address - Country:US
Practice Address - Phone:305-256-5067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-16
Last Update Date:2022-01-11
Deactivation Date:2015-12-17
Deactivation Code:
Reactivation Date:2022-01-11
Provider Licenses
StateLicense IDTaxonomies
FL876124133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered