Individual
ANGELA CHARISSE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
1108 SUMMER BREEZE DR, BRANDON, FL 33511-4079
(214) 257-4480
Mailing address
1108 SUMMER BREEZE DR, BRANDON, FL 33511-4079
(214) 257-4480
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86028496
FL
Other
Enumeration date
02/20/2019
Last updated
11/27/2019
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