| Doctor Name: | GLORIA G FULLER |
| NPI Number: | 1083894372 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.D |
| License Number: | ND1284 |
| Business Practice Address: | 10300 Sw 216th St Cutler Bay, FL - 331901003 |
| Business Phone Number: | 3055991015 |
| Business Fax Number: | 7863365000 |
| Mailing Address: | 10300 Sw 216th St, CUTLER BAY |
| State: | FL |
| Postal Code: | 331901003 |
| Phone Number: | 3055991015 |
| Fax Number: | 7863365000 |
| NPI Enumeration Date: | 11/05/2007 |
| NPI Last Update Date: | 11/05/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133VN1006X |
| License Number: | ND1284 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | Nutrition, Metabolic |
| Taxonomy Definition: | |