MEDICARE: CAROLINE GERARD MS, LDN, RDN

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	133NN1002X	Nutrition Education Nutritionist
2	133VN1005X	Renal Nutrition Registered Dietitian
3	133V00000X	Registered Dietitian	FL

General Provider Information

NPI Number	:	1225926801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINE GERARD MS, LDN, RDN

Provider Business Mailing Address
First Line	:	4631 WOODLAND CORPORATE BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-2442
Country	:	US
Telephone Number	:	727-342-0796
Fax Number	:

Provider Business Practice Location Address
First Line	:	4631 WOODLAND CORPORATE BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-2442
Country	:	US
Telephone Number	:	727-342-0796
Fax Number	:

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

Provider Enumeration Date	:	06/24/2025
Last Update Date	:	06/24/2025

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