Anderson, Tina Marie

Anderson, Tina Marie is an sole proprietor health care provider with primary practice located at 501 Del Prado Blvd S , Cape Coral FL 33990-2618. She recently has 3 registered licenses in different health care specialties including Dietary & Nutritional Service Providers / Nutrition, Education, Dietary & Nutritional Service Providers / Dietitian, Registered, Dietary & Nutritional Service Providers / Nutritionist. Dietary & Nutritional Service Providers / Nutritionist is her primary health care specialty. Anderson, Tina Marie can be contacted via phone (239) 424-3120.

Contact Information

Primary practice address
501 Del Prado Blvd S Cape Coral FL 33990-2618
Phone: (239) 424-3120
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Nutrition, Education 133NN1002X ND11044 Florida
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 164.000203 Illinois
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X ND11044 Florida
Dietary & Nutritional Service Providers / Nutritionist 133N00000X ND11044 Florida

Profile Details

NPI number 1235536293
LBN Legal business name Anderson, Tina Marie
Credentials RD,LDN, MPH, CDE
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 19th, 2014
Last updated Mar 6th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235536293 NPPES
Florida MEDICAID 121494700

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