Individual
MONIQUE BLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD/LDN
Contact information
Practice address
2324 SW VALNERA ST, PORT ST LUCIE, FL 34953-2431
(772) 418-4761
Mailing address
2324 SW VALNERA ST, PORT ST LUCIE, FL 34953-2431
(772) 418-4761
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND7967
FL
Other
Enumeration date
08/16/2022
Last updated
08/16/2022
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