Individual
SUSAN RICARDO BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ND
Contact information
Practice address
1259 S BEACH ST APT 1105, DAYTONA BEACH, FL 32114
(386) 527-9178
Mailing address
1259 S BEACH ST APT 1105, DAYTONA BEACH, FL 32114-6328
(386) 527-9178
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND4064
FL
Other
Enumeration date
07/18/2012
Last updated
07/15/2019
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