Individual
MRS. MARY ELLEN SMITH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
10000 BAY PINES BLVD, NFS #120, BAY PINES, FL 33744
(727) 398-6661
Mailing address
8315 139TH ST, SEMINOLE, FL 33776-2940
(727) 397-7851
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND423
FL
Other
Enumeration date
06/10/2006
Last updated
07/08/2007
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