Individual
MRS. JENNIFER NICOLE WASKOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D., L.D.
Contact information
Practice address
2002 E 26TH AVE, TAMPA, FL 33605-1223
(813) 307-8015
(813) 272-5408
Mailing address
2002 E 26TH AVE, TAMPA, FL 33605-1223
(813) 307-8015
(813) 272-5408
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND4792
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AI178Y
MEDICARE
FL
Enumeration date
08/16/2007
Last updated
06/12/2013
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