Provider Demographics
NPI:1285771386
Name:DELANEY CAMHI, LISA (RD MS LD/N)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:
Last Name:DELANEY CAMHI
Suffix:
Gender:F
Credentials:RD MS LD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6678 NW 42ND WAY
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-4041
Mailing Address - Country:US
Mailing Address - Phone:786-543-1044
Mailing Address - Fax:561-807-6807
Practice Address - Street 1:2201 NW CORPORATE BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-7337
Practice Address - Country:US
Practice Address - Phone:786-543-1044
Practice Address - Fax:561-807-6807
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND3321133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE7121AOtherMEDICARE PART B ID