MEDICARE: KERRY MCCARTHY MS, RD, LDN, CEDS-C

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	ND7786	FL

General Provider Information

NPI Number	:	1154726875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERRY MCCARTHY MS, RD, LDN, CEDS-C

Provider Business Mailing Address
First Line	:	4451 NE 13TH TER
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33334-4726
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1915 NE 45TH ST STE 210
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-5100
Country	:	US
Telephone Number	:	954-641-2210
Fax Number	:

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

Provider Enumeration Date	:	10/23/2014
Last Update Date	:	06/26/2025

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