Individual
JEANETTE POILLUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD/N
Contact information
Practice address
3700 NW 88TH AVE, 102, SUNRISE, FL 33351-6556
(954) 817-7508
Mailing address
3700 NW 88TH AVE, 102, SUNRISE, FL 33351-6556
(954) 817-7508
Taxonomy
Speciality
Code
Description
License number
State
133VN1005X
Renal Nutrition Registered Dietitian
Primary
ND4784
FL
Other
Enumeration date
01/11/2012
Last updated
01/11/2012
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