Provider Demographics
NPI:1457729675
Name:BENDER-SIBBIO, JULIE ANN (RDN, LDN, CWC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:BENDER-SIBBIO
Suffix:
Gender:F
Credentials:RDN, LDN, CWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 S EAST AVE STE 209
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2329
Mailing Address - Country:US
Mailing Address - Phone:214-986-1024
Mailing Address - Fax:
Practice Address - Street 1:1217 S EAST AVE STE 209
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2329
Practice Address - Country:US
Practice Address - Phone:214-986-1024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND5599133NN1002X, 133VN1006X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic