Mary Ann B Florestan, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

001660 Issued in GA

Practice address

4757 Canton Rd
Suite 110
Marietta, GA 30066-3234

Phone

(770) 517-0105

Fax

(770) 517-0105

NPI assigned

Jan 2, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477610095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4757 CANTON RD, NE",
            "address_2": "SUITE 110",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300663234",
            "telephone_number": "770-517-0105",
            "fax_number": "770-517-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4757 CANTON RD",
            "address_2": "SUITE 110",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300663234",
            "telephone_number": "770-517-0105",
            "fax_number": "770-517-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORESTAN",
        "first_name": "MARY ANN",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "RD, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "001660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10040673",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "332644",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sabrina Fleming, LPN
• Samuel S Fleming, M.D.
• Evelyn Flemons, D.C.
• Brynne Borner Flick
• Elliot Flom, LAPC, NCC
• Florida Autism Center
• Jamila Flowers, DC
• Talia Chanae Flowers
• Deidre Patrice Floyd, NP
• Ethan Scott Floyd, PT, DPT

• Registered Dietitian in Marietta, GA
• Providers in Marietta, GA by specialty
• Registered Dietitian in Georgia

• 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.