Provider Demographics
NPI:1306030812
Name:BARTLETT, CHRISTINA RODRIGUEZ (RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:RODRIGUEZ
Last Name:BARTLETT
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1469 CRANE CREEK BLVD
Mailing Address - Street 2:
Mailing Address - City:VIERA
Mailing Address - State:FL
Mailing Address - Zip Code:32940-6825
Mailing Address - Country:US
Mailing Address - Phone:321-917-2726
Mailing Address - Fax:
Practice Address - Street 1:1469 CRANE CREEK BLVD
Practice Address - Street 2:
Practice Address - City:VIERA
Practice Address - State:FL
Practice Address - Zip Code:32940-6825
Practice Address - Country:US
Practice Address - Phone:321-917-2726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND4462133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered