Erica Kukulka Blake MS, RD, LD/N

NPI 1225330178 - Dietitian, Registered - 133V00000X

NPI Details
NPI 1225330178
Gender Female
Enumeration Date 11/29/2010
Last Updated 11/29/2010
Entity Type Individual
Active Over 6 years ago
Practice Location
2000 SW ARCHER RD
G1110
GAINESVILLE FL, 32608-1136, US
Phone (352) 265-0111
Fax
Business Location
1600 SW ARCHER RD
GAINESVILLE FL, 32610-3003, US
Phone
Fax
Toxanomy
Taxonomy Code 133V00000X
License State Florida
License Number ND5444
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According to our database, Erica Kukulka Blake MS, RD, LD/N NPI is 1225330178, taxonomy code is 133V00000X and license number is ND5444, license state is located at Florida. Erica Kukulka Blake MS, RD, LD/N physically located at 2000 Sw Archer Rd, Gainesville FL, 32608-1136. NPI Number Erica Kukulka Blake MS, RD, LD/N has the Individual type.

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1225330178 NPI number is provided on an as is basis without warranty of any kind. 1225330178 is maintained by the National Plan & Provider Enumeration System. The contents of Erica Kukulka Blake MS, RD, LD/N are for informational purposes only.