Provider Demographics
NPI:1225821325
Name:EKENSTAM, KASEY (RD, LDN)
Entity type:Individual
Prefix:MRS
First Name:KASEY
Middle Name:
Last Name:EKENSTAM
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 SE 1ST AVE STE 200-112
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-2161
Mailing Address - Country:US
Mailing Address - Phone:352-234-3071
Mailing Address - Fax:
Practice Address - Street 1:8970 SE 49TH COURT RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34480-4209
Practice Address - Country:US
Practice Address - Phone:352-817-5802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-22
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND9583133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered