Provider Demographics
NPI:1023689221
Name:GAVIRIA, DEBORAH ANNE (RD RDN)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANNE
Last Name:GAVIRIA
Suffix:
Gender:F
Credentials:RD RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 WESR HIGHLAND AVE.
Mailing Address - Street 2:HCA CITRUS MEMORIAL HOSPITAL
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34452
Mailing Address - Country:US
Mailing Address - Phone:352-344-6702
Mailing Address - Fax:
Practice Address - Street 1:502 WEST HIGHLAND AVE
Practice Address - Street 2:NUTRITION SERVICES
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34452
Practice Address - Country:US
Practice Address - Phone:352-344-6701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND6378133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered