Provider Demographics
NPI:1194375451
Name:SILVERSMITH, HEATHER (RD LD/N)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:SILVERSMITH
Suffix:
Gender:F
Credentials:RD LD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:983 WINDWARD WAY
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327
Mailing Address - Country:US
Mailing Address - Phone:954-270-0913
Mailing Address - Fax:
Practice Address - Street 1:1875 NORTH CORPORATE LAKES BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326
Practice Address - Country:US
Practice Address - Phone:954-217-2444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND6873133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered