Provider Demographics
NPI:1457974537
Name:BEIL, ELIZABETH RAE (RDN)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:RAE
Last Name:BEIL
Suffix:
Gender:
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 N MERIDIAN AVE UNIT 1329
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-3994
Mailing Address - Country:US
Mailing Address - Phone:937-578-3716
Mailing Address - Fax:
Practice Address - Street 1:101 N MERIDIAN AVE UNIT 1329
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-3994
Practice Address - Country:US
Practice Address - Phone:937-578-3716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-22
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.08316133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty