MEDICARE: SHARON ANNE TILBE R.D N.D.

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	ND4683	FL

General Provider Information

NPI Number	:	1265535579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON ANNE TILBE R.D N.D.

Provider Business Mailing Address
First Line	:	PO BOX 2147
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33902-2147
Country	:	US
Telephone Number	:	239-424-1400
Fax Number	:	239-424-1421

Provider Business Practice Location Address
First Line	:	708 DEL PRADO BLVD
Second Line	:	SUITE 1
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-5616
Country	:	US
Telephone Number	:	239-573-5741
Fax Number	:	239-574-0101

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

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	12/22/2016

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