Provider Demographics
NPI:1194914895
Name:BRANDWEIN, MERYL (RD/LDN)
Entity type:Individual
Prefix:
First Name:MERYL
Middle Name:
Last Name:BRANDWEIN
Suffix:
Gender:F
Credentials:RD/LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8624 GRIFFIN RD
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33328-3719
Mailing Address - Country:US
Mailing Address - Phone:954-727-9006
Mailing Address - Fax:954-280-6566
Practice Address - Street 1:916 GULFSTREAM CT
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33327-2139
Practice Address - Country:US
Practice Address - Phone:954-654-0877
Practice Address - Fax:954-389-2113
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-18
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND4544133VN1004X, 133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric