Provider Demographics
NPI:1881948347
Name:KASNER, ARLENE LILLIAN (NC)
Entity type:Individual
Prefix:MRS
First Name:ARLENE
Middle Name:LILLIAN
Last Name:KASNER
Suffix:
Gender:F
Credentials:NC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8863 SUNSCAPE LN
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-5053
Mailing Address - Country:US
Mailing Address - Phone:561-482-8257
Mailing Address - Fax:561-483-0114
Practice Address - Street 1:3475 SHERIDAN ST
Practice Address - Street 2:SUITE 309
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3663
Practice Address - Country:US
Practice Address - Phone:954-986-6400
Practice Address - Fax:561-483-0114
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-06
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLNC 507133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLNC 507OtherLICENSED NUTRITIONIST