| Doctor Name: | MS. MARY H BOHANNON |
| NPI Number: | 1518187749 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RD LDN |
| License Number: | ND00000297 |
| Business Practice Address: | 4001 Newberry Rd Suite C Iv Gainesville, FL - 32607 |
| Business Phone Number: | 3523744449 |
| Business Fax Number: | 3523744464 |
| Mailing Address: | 12208 Sw 16th St, MICANOPY |
| State: | FL |
| Postal Code: | 32667 |
| Phone Number: | 3524663864 |
| Fax Number: | |
| NPI Enumeration Date: | 04/30/2007 |
| NPI Last Update Date: | 07/20/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | ND00000297 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |