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NPI Code Detail

MEDICARE: JENNIFER BRODER KATZ RD, LD,N,CNSD

MEDICARE: JENNIFER BRODER KATZ RD, LD,N,CNSD
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
1133N00000XNutritionistND3660FL
2133NN1002XNutrition Education NutritionistND3660FL
3133V00000XRegistered DietitianND3660FL
4133VN1006XMetabolic Nutrition Registered DietitianND3660FL

General Provider Information

NPI Number : 1821149113
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER BRODER KATZ RD, LD,N,CNSD
Provider Business Mailing Address
First Line : 1013 NORMANDY TRACE RD
Second Line :
City : TAMPA
State : FL
Zip : 33602-5777
Country : US
Telephone Number : 813-857-2520
Fax Number :
Provider Business Practice Location Address
First Line : 1013 NORMANDY TRACE RD
Second Line :
City : TAMPA
State : FL
Zip : 33602-5777
Country : US
Telephone Number : 813-857-2520
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2007
Last Update Date : 06/07/2011

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