Healthcare Provider Details

I. General information

NPI: 1508909193
Provider Name (Legal Business Name): REBEKAH MAE BURNS R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBEKAH BURNS SAAR

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 03/30/2025
Certification Date: 03/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5345 PEACH DR
PACE FL
32571-2778
US

IV. Provider business mailing address

5345 PEACH DR
PACE FL
32571-2778
US

V. Phone/Fax

Practice location:
  • Phone: 864-430-2425
  • Fax:
Mailing address:
  • Phone: 864-430-2425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number967539
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: