Provider Demographics
NPI:1518785260
Name:ROBINSON, LAUREN WONG (RD, LDN)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:WONG
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:KRISTINE
Other - Last Name:WONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:7600 MAJORCA PL APT 2014
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-5541
Mailing Address - Country:US
Mailing Address - Phone:410-733-8214
Mailing Address - Fax:
Practice Address - Street 1:4950 CALYPSO CAY WAY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34746-5520
Practice Address - Country:US
Practice Address - Phone:321-286-3374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-01
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX5716133V00000X
FLND11913133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered