MEDICARE: AVA RESNICK

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	14804	FL

General Provider Information

NPI Number	:	1982563516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AVA RESNICK

Provider Business Mailing Address
First Line	:	1120 E TWIGGS ST UNIT H463
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-3126
Country	:	US
Telephone Number	:	484-466-1462
Fax Number	:

Provider Business Practice Location Address
First Line	:	1120 E TWIGGS ST UNIT H463
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-3126
Country	:	US
Telephone Number	:	484-466-1462
Fax Number	:

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

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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