MEDICARE: LEA MARRUS RIFKIN MS, RD, LDN, RYT

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	ND10813	FL

General Provider Information

NPI Number	:	1346104023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEA MARRUS RIFKIN MS, RD, LDN, RYT

Provider Business Mailing Address
First Line	:	130 PEMBROKE DR
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-4611
Country	:	US
Telephone Number	:	201-693-5358
Fax Number	:

Provider Business Practice Location Address
First Line	:	130 PEMBROKE DR
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-4611
Country	:	US
Telephone Number	:	201-693-5358
Fax Number	:

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

Provider Enumeration Date	:	12/16/2025
Last Update Date	:	12/16/2025

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