Healthcare Provider Details

I. General information

NPI: 1164860474
Provider Name (Legal Business Name): CATHERINE FRANCES EDELMAN MS,RD,LD/N,CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2013
Last Update Date: 06/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7124 BERACASA WAY
BOCA RATON FL
33433-3448
US

IV. Provider business mailing address

7124 BERACASA WAY
BOCA RATON FL
33433-3448
US

V. Phone/Fax

Practice location:
  • Phone: 561-750-7774
  • Fax: 561-392-3200
Mailing address:
  • Phone: 561-750-7774
  • Fax: 561-392-3200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License NumberND2601
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberND2601
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License NumberND2601
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: