Provider Demographics
NPI:1154656387
Name:PAYOMO, FLORIA GLORIA (RD, CDN)
Entity Type:Individual
Prefix:MS
First Name:FLORIA
Middle Name:GLORIA
Last Name:PAYOMO
Suffix:
Gender:F
Credentials:RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 OCEAN PKWY
Mailing Address - Street 2:FOOD AND NUTRITION/CONEY ISLAND HOSPITAL
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-7745
Mailing Address - Country:US
Mailing Address - Phone:718-616-4183
Mailing Address - Fax:718-616-4791
Practice Address - Street 1:2601 OCEAN PKWY
Practice Address - Street 2:FOOD AND NUTRITION/CONEY ISLAND HOSPITAL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-7745
Practice Address - Country:US
Practice Address - Phone:718-616-4183
Practice Address - Fax:718-616-4791
Is Sole Proprietor?:No
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002004-1133N00000X
IL488421133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered