Provider Demographics
NPI:1043391113
Name:PAZDER, NADINE (RD, LD/N)
Entity Type:Individual
Prefix:
First Name:NADINE
Middle Name:
Last Name:PAZDER
Suffix:
Gender:F
Credentials:RD, LD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12249 137TH ST
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33774-3021
Mailing Address - Country:US
Mailing Address - Phone:727-462-7459
Mailing Address - Fax:727-462-7468
Practice Address - Street 1:MORTON PLANT HOSPITAL
Practice Address - Street 2:300 PINELLAS ST
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3982
Practice Address - Country:US
Practice Address - Phone:727-462-7459
Practice Address - Fax:727-462-7468
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0000741133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU1536ZMedicare ID - Type Unspecified