Provider Demographics
NPI:1407604622
Name:SOLLIE ARNOLD BASHER
Entity type:Organization
Organization Name:SOLLIE ARNOLD BASHER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:SOLLIE
Authorized Official - Middle Name:ARNOLD
Authorized Official - Last Name:BASHER
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN
Authorized Official - Phone:954-817-0000
Mailing Address - Street 1:12884 STONEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33330-1264
Mailing Address - Country:US
Mailing Address - Phone:954-817-0000
Mailing Address - Fax:
Practice Address - Street 1:150 S PINE ISLAND RD STE 300
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2665
Practice Address - Country:US
Practice Address - Phone:954-817-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty