Provider Demographics
NPI:1699963140
Name:ALIX B LANDMAN MPH RD & ASSOCIATES,INC
Entity type:Organization
Organization Name:ALIX B LANDMAN MPH RD & ASSOCIATES,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALIX
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RD, MPH,CDE
Authorized Official - Phone:954-792-7303
Mailing Address - Street 1:10801 NW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1549
Mailing Address - Country:US
Mailing Address - Phone:954-792-7303
Mailing Address - Fax:
Practice Address - Street 1:7901 SW 6TH CT STE 320
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-3283
Practice Address - Country:US
Practice Address - Phone:954-792-7303
Practice Address - Fax:954-792-7656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-10
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND1628133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty