Provider Demographics
NPI:1457515926
Name:DEAN, SHEILA G (DSC,RD,LD, CCN,CDE)
Entity type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:G
Last Name:DEAN
Suffix:
Gender:F
Credentials:DSC,RD,LD, CCN,CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4808 JEWELL TER
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-2692
Mailing Address - Country:US
Mailing Address - Phone:727-781-4326
Mailing Address - Fax:
Practice Address - Street 1:4808 JEWELL TER
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34685-2692
Practice Address - Country:US
Practice Address - Phone:727-781-4326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-15
Last Update Date:2010-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND0002978133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered