Provider Demographics
NPI:1992993422
Name:GERACI, MICHELE L (MS, RD, LD)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:L
Last Name:GERACI
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14840 JETTY LN
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-9633
Mailing Address - Country:US
Mailing Address - Phone:561-685-2434
Mailing Address - Fax:561-685-2434
Practice Address - Street 1:14840 JETTY LN
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-9633
Practice Address - Country:US
Practice Address - Phone:561-685-2434
Practice Address - Fax:561-685-2434
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-10
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND2754133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered