Provider Demographics
NPI:1457031692
Name:GAIAS, TAYLOR ALEXANDRA (RD, LD/N)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ALEXANDRA
Last Name:GAIAS
Suffix:
Gender:F
Credentials:RD, LD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6418 E MACLAURIN DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-1170
Mailing Address - Country:US
Mailing Address - Phone:813-310-9584
Mailing Address - Fax:
Practice Address - Street 1:6418 E MACLAURIN DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-1170
Practice Address - Country:US
Practice Address - Phone:813-310-9584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND11417133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered