Marilyn E Panganiban, LD/N

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

ND1062 Issued in FL

Practice address

2444 Mayport Rd
#12
Atlantic Beach, FL 32233-6816

Phone

(904) 270-2580

Fax

(904) 270-2584

NPI assigned

Jun 4, 2006

Last updated

Oct 29, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351468800000",
    "number": "1396783759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 W 6TH ST",
            "address_2": "MC #24",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322064324",
            "telephone_number": "904-665-2410",
            "fax_number": "904-630-3316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2444 MAYPORT RD",
            "address_2": "#12",
            "city": "ATLANTIC BEACH",
            "state": "FL",
            "postal_code": "322336816",
            "telephone_number": "904-270-2580",
            "fax_number": "904-270-2584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANGANIBAN",
        "first_name": "MARILYN",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "LD/N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-04",
        "last_updated": "2012-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND1062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katharine Cassandra Nix, ARNP, FNP-BC
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• Shavonne Orr
• Ryan Parker
• John C Perrotto, D.O.
• Susanne Podzamsky
• Mark Alan Popp, O.D.
• Linda Nell Porter, LMT

• Registered Dietitian in Atlantic Beach, FL
• Providers in Atlantic Beach, FL by specialty
• Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2012; 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.