Provider Demographics
NPI:1588951214
Name:BAKOVIC, LENA (MS, RDN, CNSC)
Entity type:Individual
Prefix:
First Name:LENA
Middle Name:
Last Name:BAKOVIC
Suffix:
Gender:F
Credentials:MS, RDN, CNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N US HIGHWAY 1 STE D10
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477-5135
Mailing Address - Country:US
Mailing Address - Phone:561-255-7697
Mailing Address - Fax:
Practice Address - Street 1:201 N US HIGHWAY 1 STE D10
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477-5135
Practice Address - Country:US
Practice Address - Phone:561-255-7697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-01
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty