Individual
MRS. TAMMY ALVAREZ WIEDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD,N
Contact information
Practice address
3100 UNIVERSITY BLVD S, SUITE 220, JACKSONVILLE, FL 32216-2758
(904) 724-2043
Mailing address
1076 FEATHERWOOD CT, ATLANTIC BEACH, FL 32233-6913
(904) 247-5588
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND4613
FL
Other
Enumeration date
05/24/2007
Last updated
07/08/2007
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