Provider Demographics
NPI:1235943739
Name:MILLS, PATRICIA (RD, LDN)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:MILLS
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:PATTI
Other - Middle Name:
Other - Last Name:MILLS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD, LDN
Mailing Address - Street 1:1331 SW 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-7423
Mailing Address - Country:US
Mailing Address - Phone:954-254-3726
Mailing Address - Fax:
Practice Address - Street 1:1331 SW 25TH AVE
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-7423
Practice Address - Country:US
Practice Address - Phone:954-254-3726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND13983133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered