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Individual

ILEANA TELLECHEA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, RDN, LD

Contact information

Practice address
321 SW 136TH AVE, MIAMI, FL 33184-1021
(305) 226-1145
Mailing address
321 SW 136TH AVE, MIAMI, FL 33184-1021
(305) 226-1145

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND1787
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R591336
DIETETIC REGISTRATION ADA
Enumeration date
12/23/2005
Last updated
06/24/2021
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