Provider Demographics
NPI:1134980998
Name:WOLFSON, GABRIELA REMONDA (RD LDN)
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:REMONDA
Last Name:WOLFSON
Suffix:
Gender:F
Credentials:RD LDN
Other - Prefix:
Other - First Name:GABRIELA
Other - Middle Name:FERNANDA
Other - Last Name:REMONDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11113 BISCAYNE BLVD UNIT 2051
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-3443
Mailing Address - Country:US
Mailing Address - Phone:561-299-1164
Mailing Address - Fax:561-567-7756
Practice Address - Street 1:11113 BISCAYNE BLVD UNIT 2051
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-3443
Practice Address - Country:US
Practice Address - Phone:561-299-1164
Practice Address - Fax:561-587-7756
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND5452133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered