Individual
SHOBA BALAJI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
312 OSPREY NEST CT, PONTE VEDRA BEACH, FL 32082-6283
(508) 963-8537
Mailing address
312 OSPREY NEST CT, PONTE VEDRA BEACH, FL 32082-6283
(508) 963-8537
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86145501
FL
133V00000X
Registered Dietitian
ND10022
FL
Other
Enumeration date
11/07/2021
Last updated
11/07/2021
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