Provider Demographics
NPI:1629591672
Name:FIGUEROA, FABIOLA (MBA, RD, CDE)
Entity Type:Individual
Prefix:
First Name:FABIOLA
Middle Name:
Last Name:FIGUEROA
Suffix:
Gender:F
Credentials:MBA, RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38135 MARKET SQ
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-7505
Mailing Address - Country:US
Mailing Address - Phone:352-567-0188
Mailing Address - Fax:
Practice Address - Street 1:38135 MARKET SQ STE 107
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-7505
Practice Address - Country:US
Practice Address - Phone:813-280-7600
Practice Address - Fax:813-377-1706
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-21
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND5817133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty