Provider Demographics
NPI:1396419073
Name:PASSABILE, VALERIE (RDN)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:
Last Name:PASSABILE
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7006 HAMMOCK TRACE DR
Mailing Address - Street 2:
Mailing Address - City:VIERA
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7974
Mailing Address - Country:US
Mailing Address - Phone:321-313-2321
Mailing Address - Fax:
Practice Address - Street 1:1705 BERGLUND LN
Practice Address - Street 2:
Practice Address - City:VIERA
Practice Address - State:FL
Practice Address - Zip Code:32940-6444
Practice Address - Country:US
Practice Address - Phone:484-788-5156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-05
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND6608133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered