MEDICARE: SABRINA M FICHERA MSH, RD, LDN

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	DX3163	MD
2	133V00000X	Registered Dietitian	ND7867	FL

General Provider Information

NPI Number	:	1841636958
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SABRINA M FICHERA MSH, RD, LDN

Provider Business Mailing Address
First Line	:	4300 MARSH LANDING BLVD STE 101
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-1419
Country	:	US
Telephone Number	:	904-686-2690
Fax Number	:

Provider Business Practice Location Address
First Line	:	4300 MARSH LANDING BLVD STE 101
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-1419
Country	:	US
Telephone Number	:	904-686-2690
Fax Number	:

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

Provider Enumeration Date	:	05/15/2013
Last Update Date	:	02/23/2022

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