Provider Demographics
NPI:1528133295
Name:KIMELMAN, ROSEMARIE L (RD, LD, CDE)
Entity type:Individual
Prefix:MS
First Name:ROSEMARIE
Middle Name:L
Last Name:KIMELMAN
Suffix:
Gender:F
Credentials:RD, LD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12990 SW 56TH ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHWEST RANCHES
Mailing Address - State:FL
Mailing Address - Zip Code:33330-3230
Mailing Address - Country:US
Mailing Address - Phone:954-434-0211
Mailing Address - Fax:954-680-8639
Practice Address - Street 1:12990 SW 56TH ST
Practice Address - Street 2:
Practice Address - City:SOUTHWEST RANCHES
Practice Address - State:FL
Practice Address - Zip Code:33330-3230
Practice Address - Country:US
Practice Address - Phone:954-434-0211
Practice Address - Fax:954-680-8639
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND20133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered