Individual
CRISTINA LYN DETHLOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD/N
Contact information
Practice address
13330 USF LAUREL DR, TAMPA, FL 33612-6601
(813) 974-2201
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND4385
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N0221
BLUE CROSS BLUE SHIELD
FL
Enumeration date
02/02/2006
Last updated
02/17/2022
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