Provider Demographics
NPI:1821055955
Name:NAKSHABENDI, EMAN (MS, RD, LD/N)
Entity Type:Individual
Prefix:
First Name:EMAN
Middle Name:
Last Name:NAKSHABENDI
Suffix:
Gender:F
Credentials:MS, RD, LD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5041 WESLEY DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-1376
Mailing Address - Country:US
Mailing Address - Phone:813-363-3555
Mailing Address - Fax:
Practice Address - Street 1:5041 WESLEY DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-1376
Practice Address - Country:US
Practice Address - Phone:813-363-3555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND 3503133V00000X
ILRD 881816133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU5122YMedicare PIN
FLU5122AMedicare ID - Type UnspecifiedINDIVIDUAL NUMBER
FLK0668Medicare ID - Type UnspecifiedGROUP NUMBER
FLU5122BMedicare ID - Type UnspecifiedGROUP MEDICARE ID