Individual
DIANE MOLITOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA,RD
Contact information
Practice address
859 BAYOU VIEW DR, BRANDON, FL 33510-2092
(813) 681-6607
Mailing address
859 BAYOU VIEW DR, BRANDON, FL 33510-2092
(813) 681-6607
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND 842
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ND 842
DIETITIAN
FL
Enumeration date
07/05/2006
Last updated
07/08/2007
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