Provider Demographics
NPI:1407648892
Name:RUEDA, VERONICA (RD)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:RUEDA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:VERONICA
Other - Middle Name:
Other - Last Name:RUEDA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD/LD
Mailing Address - Street 1:9535 NW 28TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-5036
Mailing Address - Country:US
Mailing Address - Phone:704-689-8253
Mailing Address - Fax:
Practice Address - Street 1:9535 NW 28TH ST
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-5036
Practice Address - Country:US
Practice Address - Phone:704-689-8253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND13937133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered