Provider Demographics
NPI:1639146756
Name:JEFFREY, JANET LUNA (RD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:LUNA
Last Name:JEFFREY
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 1:5802 N 30TH STREET
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33610-1469
Mailing Address - Country:US
Mailing Address - Phone:813-236-5100
Mailing Address - Fax:813-237-5402
Practice Address - Street 1:5802 N 30TH STREET
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-1469
Practice Address - Country:US
Practice Address - Phone:813-236-5100
Practice Address - Fax:813-237-5402
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLN04081133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
RD877604OtherCOMMISSION FOR DIETETIC
FLU28222Medicare ID - Type Unspecified