Provider Demographics
NPI:1104403237
Name:DELICE, JAMECIA (RD, LDN)
Entity type:Individual
Prefix:
First Name:JAMECIA
Middle Name:
Last Name:DELICE
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:JAMECIA
Other - Middle Name:
Other - Last Name:MILLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MILLS
Mailing Address - Street 1:4107 CHATHAM OAK CT APT 311
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-5192
Mailing Address - Country:US
Mailing Address - Phone:813-291-8677
Mailing Address - Fax:
Practice Address - Street 1:3000 MEDICAL PARK DR STE 490
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-6600
Practice Address - Country:US
Practice Address - Phone:813-971-2470
Practice Address - Fax:813-971-2491
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND9796133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered