MEDICARE: ARIA HETZENDORFER 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	ND11213	FL

General Provider Information

NPI Number	:	1821808874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIA HETZENDORFER RDN

Provider Business Mailing Address
First Line	:	4560 40TH AVE N
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33714-3410
Country	:	US
Telephone Number	:	727-330-5990
Fax Number	:

Provider Business Practice Location Address
First Line	:	4560 40TH AVE N
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33714-3410
Country	:	US
Telephone Number	:	727-330-5990
Fax Number	:

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

Provider Enumeration Date	:	01/11/2025
Last Update Date	:	01/11/2025

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Directions to “ ARIA HETZENDORFER RDN” Practice Location

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