Individual
MRS. MARY JO FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
300 PINELLAS ST, CLEARWATER, FL 33756-3804
(727) 462-7000
Mailing address
2656 PINEWOOD DR, DUNEDIN, FL 34698-6537
(727) 734-8412
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
155879
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ND 228
LICENSE
FL
01
—
R155879
REGISTRATION
—
Enumeration date
12/19/2006
Last updated
07/08/2007
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