Individual
MARYORI YULDANA TELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LDN, CDM, CFPP
Contact information
Practice address
850 6TH AVE S STE 300, JACKSONVILLE BEACH, FL 32250-4256
(954) 654-1139
Mailing address
1103 16TH AVE N, JACKSONVILLE BEACH, FL 32250-3753
(954) 654-1139
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND8502
FL
Other
Enumeration date
09/26/2022
Last updated
09/26/2022
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