Provider Demographics
NPI:1851439491
Name:REEMELIN, ANGELA N (RD)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:N
Last Name:REEMELIN
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 1:601 LORN CT
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-4228
Mailing Address - Country:US
Mailing Address - Phone:904-276-4830
Mailing Address - Fax:904-298-0283
Practice Address - Street 1:601 LORN CT
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4228
Practice Address - Country:US
Practice Address - Phone:904-276-4830
Practice Address - Fax:904-298-0283
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0000095133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered