Individual
KIMBERLY SAMANTHA RILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
6146 100TH AVE E, PARRISH, FL 34219-4557
(551) 265-8405
Mailing address
6146 100TH AVE E, PARRISH, FL 34219-4557
(551) 265-8405
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND 5730
FL
133V00000X
Registered Dietitian
ND5730
FL
Other
Enumeration date
06/15/2006
Last updated
08/17/2021
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