Provider Demographics
NPI:1528722030
Name:LLODRA, JUDY (RD/LDN)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:
Last Name:LLODRA
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 1:212 PARK PL
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7564
Mailing Address - Country:US
Mailing Address - Phone:561-254-5818
Mailing Address - Fax:
Practice Address - Street 1:212 PARK PL
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7564
Practice Address - Country:US
Practice Address - Phone:561-254-5818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-30
Last Update Date:2021-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND2407133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered