MEDICARE: BETH ELLEN DILUGLIO MS, RD, CCN, LD/N

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	ND2046	FL
2	133VN1006X	Metabolic Nutrition Registered Dietitian	ND2046	FL

General Provider Information

NPI Number	:	1073822052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETH ELLEN DILUGLIO MS, RD, CCN, LD/N

Provider Business Mailing Address
First Line	:	2260 21ST ST SW
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34117-4606
Country	:	US
Telephone Number	:	561-247-2384
Fax Number	:

Provider Business Practice Location Address
First Line	:	2260 21ST ST SW
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34117-4606
Country	:	US
Telephone Number	:	561-247-2384
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2010
Last Update Date	:	09/24/2010

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