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General NPI Number Information
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NPI Number | 1952908204
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Entity Type | Individual
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Provider Name | KIMBERLY MEZZETTI RDN, LDN
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Gender | Female
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Dates
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Enumeration Date | 10/08/2020
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Last Update Date | 11/01/2023
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Provider Practice Location Address
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Address Line | 4826 SW 49TH RD
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City | OCALA
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State | FL
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Zip | 34474-6299
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Country | US
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Telephone | 561-654-6534
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Fax |
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Provider Business Mailing Address
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Address Line | 1439 S LADERA TER
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City | INVERNESS
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State | FL
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Zip | 34452-3631
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Country | US
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Telephone | 561-654-6534
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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 | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | 10037
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License Number State | FL
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