Provider Demographics
NPI:1164904678
Name:ALBARELLA, KATHARINE (RD, LDN)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:
Last Name:ALBARELLA
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12007 MOCCASIN CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-8976
Mailing Address - Country:US
Mailing Address - Phone:203-535-7871
Mailing Address - Fax:
Practice Address - Street 1:905 S. LAKE JESSUP AVE
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765
Practice Address - Country:US
Practice Address - Phone:203-535-7871
Practice Address - Fax:407-542-8795
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6893133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered