Provider Demographics
NPI:1801007356
Name:CANDELARIA, SABRINA (MPH, RD, LDN)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:CANDELARIA
Suffix:
Gender:F
Credentials:MPH, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 NW 12 AVE
Mailing Address - Street 2:UNIVERSITY OF MIAMI EARLY STEPS PROGRAM
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1005
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1601 NW 12 AVE
Practice Address - Street 2:UNIVERSITY OF MIAMI EARLY STEPS PROGRAM
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1005
Practice Address - Country:US
Practice Address - Phone:305-243-6848
Practice Address - Fax:305-243-6385
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4793133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4793OtherNUTRITION LICENSURE