Provider Demographics
NPI:1588600225
Name:GRAMMOND, SUSAN VICTORIA (RD, LD/N)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:VICTORIA
Last Name:GRAMMOND
Suffix:
Gender:F
Credentials:RD, LD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1665 PALM BEACH LAKES BLVD
Mailing Address - Street 2:SUITE B-900
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-2121
Mailing Address - Country:US
Mailing Address - Phone:561-681-2524
Mailing Address - Fax:561-681-2501
Practice Address - Street 1:1665 PALM BEACH LAKES BLVD
Practice Address - Street 2:SUITE B-900
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-2121
Practice Address - Country:US
Practice Address - Phone:561-681-2524
Practice Address - Fax:561-681-2501
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND 1999133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLND 1900OtherNUTRITIONIST LISCENSE