Provider Demographics
NPI:1164808408
Name:VALLASCIANI, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:VALLASCIANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 BISCAYNE BLVD APT 221
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-5009
Mailing Address - Country:US
Mailing Address - Phone:786-506-1945
Mailing Address - Fax:
Practice Address - Street 1:2001 BISCAYNE BLVD APT 2221
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-5018
Practice Address - Country:US
Practice Address - Phone:786-506-1945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-10
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7521133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered