Healthcare Provider Details

I. General information

NPI: 1023442068
Provider Name (Legal Business Name): DAWN SANTACROCE RDN LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2013
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3496 NW FEDERAL HWY STE F
JENSEN BEACH FL
34957-4441
US

IV. Provider business mailing address

3496 NW FEDERAL HWY STE F
JENSEN BEACH FL
34957-4441
US

V. Phone/Fax

Practice location:
  • Phone: 772-223-4916
  • Fax: 772-223-2887
Mailing address:
  • Phone: 772-223-4916
  • Fax: 772-223-2887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberND10609
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number0008341
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: