Florestan, Mary Ann B
Florestan, Mary Ann B is an sole proprietor health care provider with primary practice located at 4757 Canton Rd Suite 110, Marietta GA 30066-3234. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Florestan, Mary Ann B can be contacted via phone (770) 517-0105.Contact Information
Primary practice address
4757 Canton Rd Suite 110
Marietta GA 30066-3234
Phone: (770) 517-0105
Fax: (770) 517-0105
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dietary & Nutritional Service Providers / Dietitian, Registered | 133V00000X | 001660 | Georgia |
Profile Details
| NPI number | 1477610095 |
|---|---|
| LBN Legal business name | Florestan, Mary Ann B |
| Credentials | RD, LD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 2nd, 2007 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477610095 | NPPES |
| Georgia | Other | 10040673 | AMERIGROUP |
| Georgia | Other | 332644 | AMERIGROUP |
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