Provider Demographics
NPI:1225926801
Name:GERARD, CAROLINE (MS, LDN, RDN)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:GERARD
Suffix:
Gender:F
Credentials:MS, LDN, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4631 WOODLAND CORPORATE BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-2442
Mailing Address - Country:US
Mailing Address - Phone:727-342-0796
Mailing Address - Fax:
Practice Address - Street 1:4631 WOODLAND CORPORATE BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2442
Practice Address - Country:US
Practice Address - Phone:727-342-0796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133NN1002X, 133VN1005X
FL133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal