Provider Demographics
NPI:1295823250
Name:INGOGLIA, DANA (RD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:INGOGLIA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14804 DARTMOOR LN
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-2612
Mailing Address - Country:US
Mailing Address - Phone:980-230-9352
Mailing Address - Fax:
Practice Address - Street 1:14804 DARTMOOR LN
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-2612
Practice Address - Country:US
Practice Address - Phone:980-230-9352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND6932133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered