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General NPI Number Information
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NPI Number | 1104403237
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Entity Type | Individual
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Provider Name | JAMECIA DELICE RD, LDN
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Gender | Female
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Dates
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Enumeration Date | 03/25/2021
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Last Update Date | 08/15/2024
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Provider Practice Location Address
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Address Line | 3000 MEDICAL PARK DR STE 490
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City | TAMPA
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State | FL
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Zip | 33613-6600
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Country | US
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Telephone | 813-971-2470
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Fax | 813-971-2491
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Provider Business Mailing Address
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Address Line | 4107 CHATHAM OAK CT APT 311
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City | TAMPA
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State | FL
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Zip | 33624-5192
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Country | US
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Telephone | 813-291-8677
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | ND9796
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License Number State | FL
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