Provider Demographics
NPI:1518783026
Name:SANKAR, RACHA (PHD, RD, LD)
Entity type:Individual
Prefix:DR
First Name:RACHA
Middle Name:
Last Name:SANKAR
Suffix:
Gender:F
Credentials:PHD, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1261 SW 109TH AVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3510
Mailing Address - Country:US
Mailing Address - Phone:954-801-9957
Mailing Address - Fax:
Practice Address - Street 1:1261 SW 109TH AVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33025-3510
Practice Address - Country:US
Practice Address - Phone:954-801-9957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-29
Last Update Date:2024-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9896133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered