Provider Demographics
NPI:1336854884
Name:DRUMMER, DANIELLE ALZENA (RD)
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:ALZENA
Last Name:DRUMMER
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 1:1825 BAYHILL DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-6301
Mailing Address - Country:US
Mailing Address - Phone:609-703-3442
Mailing Address - Fax:
Practice Address - Street 1:1825 BAYHILL DRIVE
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940
Practice Address - Country:US
Practice Address - Phone:321-549-8249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-19
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX3621133V00000X
DEDN0000501133V00000X
FLND10542133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered