Provider Demographics
NPI:1962734327
Name:JANAK, KAMEY ALENE (RD, LD)
Entity type:Individual
Prefix:
First Name:KAMEY
Middle Name:ALENE
Last Name:JANAK
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5371 N HIATUS RD
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-8718
Mailing Address - Country:US
Mailing Address - Phone:866-443-5034
Mailing Address - Fax:
Practice Address - Street 1:5371 N HIATUS RD
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-8718
Practice Address - Country:US
Practice Address - Phone:866-348-0441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-09
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT81089133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered