Healthcare Provider Details

I. General information

NPI: 1902513872
Provider Name (Legal Business Name): NICOLE FRANKLIN RDN, CSO, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2022
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3220 MCMULLEN BOOTH ROAD SUITE C
CLEARWATER FL
33761-2012
US

IV. Provider business mailing address

PO BOX 749495
ATLANTA GA
30374-9495
US

V. Phone/Fax

Practice location:
  • Phone: 727-223-7485
  • Fax: 727-260-6273
Mailing address:
  • Phone: 855-963-2100
  • Fax: 813-321-1296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133VN1301X
TaxonomyOncology Nutrition Registered Dietitian
License Number86029394
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: