MEDICARE: KELI MARIE PERINO RDN

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
1	133V00000X	Registered Dietitian	ND10374	FL
2	133V00000X	Registered Dietitian	86068880	CA
3	133V00000X	Registered Dietitian	LD-D-10213594	OR
4	133V00000X	Registered Dietitian	3783	WI
5	133V00000X	Registered Dietitian	L006366	NC
6	133V00000X	Registered Dietitian	2806	OK
7	133V00000X	Registered Dietitian	D-2384	MS
8	133V00000X	Registered Dietitian	37003311A	IN
9	133V00000X	Registered Dietitian	LD-1561	NM
10	133V00000X	Registered Dietitian	DN007413	PA
11	133V00000X	Registered Dietitian	2021031912	MO
12	133V00000X	Registered Dietitian	269529	KY
13	133V00000X	Registered Dietitian	8606880	AZ

General Provider Information

NPI Number	:	1154841328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELI MARIE PERINO RDN

Provider Business Mailing Address
First Line	:	5353 E FORT LOWELL RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-1312
Country	:	US
Telephone Number	:	520-490-8452
Fax Number	:

Provider Business Practice Location Address
First Line	:	5353 E FORT LOWELL RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-1312
Country	:	US
Telephone Number	:	520-490-8452
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2017
Last Update Date	:	05/10/2025

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