Berry, Leslie

Berry, Leslie is an individual health care provider with primary practice located at 807 Childrens Way , Jacksonville FL 32207-8426. She recently has 2 registered licenses in different health care specialties including Dietary & Nutritional Service Providers / Nutrition, Pediatric, Dietary & Nutritional Service Providers / Dietitian, Registered. Dietary & Nutritional Service Providers / Nutrition, Pediatric is her primary health care specialty. Berry, Leslie can be contacted via phone (904) 697-3695.

Contact Information

Primary practice address
807 Childrens Way Jacksonville FL 32207-8426
Phone: (904) 697-3695
Fax: (302) 651-4945
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Nutrition, Pediatric 133VN1004X ND4390 Florida
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X ND4390 Florida

Profile Details

NPI number 1386032266
LBN Legal business name Berry, Leslie
Credentials Registered Dietitian (RD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 31st, 2014
Last updated Oct 5th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386032266 NPPES
Florida MEDICAID 016602100

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