Provider Demographics
NPI:1346078243
Name:KORUS, VIRGILIA DELCARMEN ZABALA (RDN, LDN)
Entity type:Individual
Prefix:
First Name:VIRGILIA
Middle Name:DELCARMEN ZABALA
Last Name:KORUS
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:VIRGILIA
Other - Middle Name:DEL CARMEN
Other - Last Name:ZABALA SANABRIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN, LDN
Mailing Address - Street 1:8659 NE 8TH TRL
Mailing Address - Street 2:
Mailing Address - City:HIGH SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32643-0568
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8659 NE 8TH TRL
Practice Address - Street 2:
Practice Address - City:HIGH SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32643-0568
Practice Address - Country:US
Practice Address - Phone:305-586-8293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND9450133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered