Leung, Doretta Laiying

Leung, Doretta Laiying 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 / Nutritionist, Dietary & Nutritional Service Providers / Dietitian, Registered. Dietary & Nutritional Service Providers / Dietitian, Registered is her primary health care specialty. Leung, Doretta Laiying can be contacted via phone (904) 697-3600.

Contact Information

Primary practice address
807 Childrens Way Jacksonville FL 32207-8426
Phone: (904) 697-3600
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Nutritionist 133N00000X ND5672 Florida
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X ND5672 Florida

Profile Details

NPI number 1255651816
LBN Legal business name Leung, Doretta Laiying
Credentials MS, RD, LD/N
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2010
Last updated Feb 21st, 2019 - about 7 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 1255651816 NPPES
Florida MEDICAID 024926700

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