Mark Dickerson, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

ND4449 Issued in FL

Practice address

1201 NW 16TH St
Miami, FL 33125-1624

Phone

(305) 575-3252

NPI assigned

Aug 9, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184634461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 NW 38TH ST",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330642738",
            "telephone_number": "954-786-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 NW 16TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331251624",
            "telephone_number": "305-575-3252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERSON",
        "first_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND4449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Dicembrino
• Daniela Maria Dicenso, D.O.
• Michael Dicenso
• Jaime Dickerson, MD
• Janell Dickerson, LCSW
• Gordon M Dickinson Jr., M.D.
• Leigh A Dickinson
• Victoria Anne Dickman, LMFT
• Charles Dickson, PSY.D
• Pamela R Dickson, MD

• Registered Dietitian in Miami, FL
• Providers in Miami, FL by specialty
• Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.