Provider Demographics
NPI:1164452355
Name:HAUSER, DOLORES M (RD)
Entity type:Individual
Prefix:MS
First Name:DOLORES
Middle Name:M
Last Name:HAUSER
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 1:9024 NW 60TH ST
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-4149
Mailing Address - Country:US
Mailing Address - Phone:954-718-8650
Mailing Address - Fax:
Practice Address - Street 1:9900 W SAMPLE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4048
Practice Address - Country:US
Practice Address - Phone:954-575-4940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND1310133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist