Provider Demographics
NPI:1245873470
Name:KHALED, MARIA (RDN, LD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:KHALED
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 N ORANGE AVE STE 847
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-2316
Mailing Address - Country:US
Mailing Address - Phone:407-698-3121
Mailing Address - Fax:407-698-3122
Practice Address - Street 1:111 N ORANGE AVE STE 847
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-2316
Practice Address - Country:US
Practice Address - Phone:407-698-3121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-21
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLDN0000003646133VN1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management