Healthcare Provider Details

I. General information

NPI: 1881948347
Provider Name (Legal Business Name): ARLENE LILLIAN KASNER NC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2012
Last Update Date: 11/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3475 SHERIDAN ST SUITE 309
HOLLYWOOD FL
33021-3663
US

IV. Provider business mailing address

8863 SUNSCAPE LN
BOCA RATON FL
33496-5053
US

V. Phone/Fax

Practice location:
  • Phone: 954-986-6400
  • Fax: 561-483-0114
Mailing address:
  • Phone: 561-482-8257
  • Fax: 561-483-0114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberNC 507
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: