Provider Demographics
NPI:1861248601
Name:BAXTER, ALURA DANNON (RD)
Entity type:Individual
Prefix:
First Name:ALURA
Middle Name:DANNON
Last Name:BAXTER
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 1:11503 SW 26TH PL APT 308
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-7545
Mailing Address - Country:US
Mailing Address - Phone:832-221-4706
Mailing Address - Fax:
Practice Address - Street 1:11503 SW 26TH PL APT 308
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-7545
Practice Address - Country:US
Practice Address - Phone:832-221-4706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND7515133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered