Provider Demographics
NPI:1932962263
Name:MARRONE, ELYSE (RD)
Entity Type:Individual
Prefix:
First Name:ELYSE
Middle Name:
Last Name:MARRONE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:ELYSE
Other - Middle Name:KAMEN
Other - Last Name:MARRONE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD
Mailing Address - Street 1:1306 SONOMA CT
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-1517
Mailing Address - Country:US
Mailing Address - Phone:561-252-7857
Mailing Address - Fax:
Practice Address - Street 1:2401 PGA BLVD # 27
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3590
Practice Address - Country:US
Practice Address - Phone:561-252-7857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND6053133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered