Provider Demographics
NPI:1871875112
Name:SZEBENI, ANDREA SUSANNE (MS, RD, LD/N)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:SUSANNE
Last Name:SZEBENI
Suffix:
Gender:F
Credentials:MS, RD, LD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 YACHT CLUB WAY
Mailing Address - Street 2:#104
Mailing Address - City:HYPOLUXO
Mailing Address - State:FL
Mailing Address - Zip Code:33462-6061
Mailing Address - Country:US
Mailing Address - Phone:305-924-7319
Mailing Address - Fax:
Practice Address - Street 1:167 YACHT CLUB WAY
Practice Address - Street 2:#104
Practice Address - City:HYPOLUXO
Practice Address - State:FL
Practice Address - Zip Code:33462-6061
Practice Address - Country:US
Practice Address - Phone:305-924-7319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND 5971133N00000X, 133V00000X
FL1044812133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist