Individual
MADISON SOUTHWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
4528 OAK RIVER CIR, VALRICO, FL 33596-7226
(813) 952-3397
Mailing address
4528 OAK RIVER CIR, VALRICO, FL 33596-7226
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
10849
FL
Other
Enumeration date
02/12/2024
Last updated
02/12/2024
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