MEDICARE: MONICA EMORY M.S.,R.D., L.D./N.

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	ND4924	FL

General Provider Information

NPI Number	:	1295777878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONICA EMORY M.S.,R.D., L.D./N.

Provider Business Mailing Address
First Line	:	319 11TH AVE NE
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33701-1925
Country	:	US
Telephone Number	:	727-643-2319
Fax Number	:

Provider Business Practice Location Address
First Line	:	319 11TH AVE NE
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33701-1925
Country	:	US
Telephone Number	:	727-643-2319
Fax Number	:

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

Provider Enumeration Date	:	06/11/2006
Last Update Date	:	07/08/2007

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