MEDICARE: SANDRA FINN LIVINGSTON RD, LD/N

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	ND2360	FL

General Provider Information

NPI Number	:	1598018095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA FINN LIVINGSTON RD, LD/N

Provider Business Mailing Address
First Line	:	800 VILLAGE SQUARE XING
Second Line	:	SUITE 209
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4540
Country	:	US
Telephone Number	:	561-371-5105
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 VILLAGE SQUARE XING
Second Line	:	SUITE 209
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4540
Country	:	US
Telephone Number	:	561-371-5105
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2012
Last Update Date	:	09/09/2014

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