Provider Demographics
NPI:1992499057
Name:GODOI, LUCIANA MAREGA (RD)
Entity type:Individual
Prefix:MISS
First Name:LUCIANA
Middle Name:MAREGA
Last Name:GODOI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 W CAMINO REAL APT 4
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-5765
Mailing Address - Country:US
Mailing Address - Phone:754-281-7626
Mailing Address - Fax:
Practice Address - Street 1:491 W CAMINO REAL APT 4
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-5765
Practice Address - Country:US
Practice Address - Phone:754-281-7626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND7945133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty