Provider Demographics
NPI:1043031537
Name:SGARLATO, LARISSA (RDN)
Entity type:Individual
Prefix:
First Name:LARISSA
Middle Name:
Last Name:SGARLATO
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 1:2149 FRANGIPANI CIR UNIT 101
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-2848
Mailing Address - Country:US
Mailing Address - Phone:239-777-2926
Mailing Address - Fax:
Practice Address - Street 1:2149 FRANGIPANI CIR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34120-2848
Practice Address - Country:US
Practice Address - Phone:239-777-2826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND3124133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered