Provider Demographics
NPI:1609350776
Name:CONSULTANT DIETITIANS OF FORT MYERS INC
Entity Type:Organization
Organization Name:CONSULTANT DIETITIANS OF FORT MYERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:FRANCO
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED DIETITIAN
Authorized Official - Phone:239-281-4908
Mailing Address - Street 1:15046 BALMORAL LOOP
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-2182
Mailing Address - Country:US
Mailing Address - Phone:239-281-4908
Mailing Address - Fax:
Practice Address - Street 1:5285 SUMMERLIN RD STE 101
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-7601
Practice Address - Country:US
Practice Address - Phone:239-281-4908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-24
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty