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Individual

ISLENA LUCETH KEYES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD, LD

Contact information

Practice address
13000 BRUCE B DOWNS BLVD, TAMPA, FL 33612
(813) 972-2000
Mailing address
13000 BRUCE B DOWNS BLVD, TAMPA, FL 33612-4745
(813) 972-2000

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
39306-DI-0
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
86058789
CDR
Enumeration date
11/14/2017
Last updated
12/05/2019
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