Provider Demographics
NPI:1922535541
Name:ADAMS, CAROL ANNETTE (MDA, RDN, LDN)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:ANNETTE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MDA, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 TAFT AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4351
Mailing Address - Country:US
Mailing Address - Phone:407-967-9675
Mailing Address - Fax:855-946-1799
Practice Address - Street 1:1155 LOUISIANA AVE STE 216
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2351
Practice Address - Country:US
Practice Address - Phone:407-967-9675
Practice Address - Fax:855-946-1799
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-12
Last Update Date:2022-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND8176133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered