Provider Demographics
NPI:1871132050
Name:ZETTY, ANDREINA M (RD, LDN)
Entity type:Individual
Prefix:MRS
First Name:ANDREINA
Middle Name:M
Last Name:ZETTY
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:ANDREINA
Other - Middle Name:
Other - Last Name:CARRENO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LDN
Mailing Address - Street 1:728 WOODHILL DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-2660
Mailing Address - Country:US
Mailing Address - Phone:954-232-0645
Mailing Address - Fax:
Practice Address - Street 1:728 WOODHILL DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2660
Practice Address - Country:US
Practice Address - Phone:954-232-0645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-05
Last Update Date:2020-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND7924133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered