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General NPI Number Information
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NPI Number | 1770435190
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Entity Type | Organization
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Legal Business Name | PEDRAM ESMAEELZADEH RD LLC
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Dates
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Enumeration Date | 02/10/2026
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 1806 WALLACE MANOR LN
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City | WINTER HAVEN
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State | FL
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Zip | 33880-1842
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Country | US
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Telephone | 678-282-7225
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Fax |
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Provider Business Mailing Address
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Address Line | 1806 WALLACE MANOR LN
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City | WINTER HAVEN
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State | FL
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Zip | 33880-1842
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIETITIAN
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Name | PEDRAM ESMAEELZADEH
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Credential | RDN, LDN
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Telephone | 678-282-7225
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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 |
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License Number State |
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