Provider Demographics
NPI:1548030638
Name:BIALOW, SARINA BLAKE (RD)
Entity type:Individual
Prefix:MS
First Name:SARINA
Middle Name:BLAKE
Last Name:BIALOW
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 1:2960 NE 207TH ST
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1447
Mailing Address - Country:US
Mailing Address - Phone:609-731-3547
Mailing Address - Fax:
Practice Address - Street 1:2960 NE 207TH ST
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1447
Practice Address - Country:US
Practice Address - Phone:609-731-3547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL86330564133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered