Provider Demographics
NPI:1003674532
Name:DEVLIN, WILLIAM SEAN (MS, RDN, LDN)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:SEAN
Last Name:DEVLIN
Suffix:
Gender:M
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4019 HABANA AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-4036
Mailing Address - Country:US
Mailing Address - Phone:904-657-9979
Mailing Address - Fax:
Practice Address - Street 1:4019 HABANA AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-4036
Practice Address - Country:US
Practice Address - Phone:904-657-9979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL86056307133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal