Doctor Name: | TEALA VANDEVEN |
NPI Number: | 1205200904 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | ND4193 |
Business Practice Address: | 5128 Sw Landing Creek Dr Palm City, FL - 349904121 |
Business Phone Number: | 9543837481 |
Business Fax Number: | |
Mailing Address: | 5128 Sw Landing Creek Dr, PALM CITY |
State: | FL |
Postal Code: | 349904121 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/18/2015 |
NPI Last Update Date: | 11/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | ND4193 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |