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MS. MARIANNE FERGUSON AYALA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
10508 GIBSONTON DR, RIVERVIEW, FL 33578-5434
(813) 390-2506
Mailing address
10508 GIBSONTON DR, RIVERVIEW, FL 33578-5434
(813) 390-2506

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND5177
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ND5177
LICENSE
FL
Enumeration date
11/17/2009
Last updated
11/17/2009
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