Provider Demographics
NPI:1427723154
Name:DIABETES DIMENSIONS
Entity type:Organization
Organization Name:DIABETES DIMENSIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:928-412-1433
Mailing Address - Street 1:12300 VONN RD APT 2204
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33774-3412
Mailing Address - Country:US
Mailing Address - Phone:928-412-1433
Mailing Address - Fax:
Practice Address - Street 1:12300 VONN RD APT 2204
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33774-3412
Practice Address - Country:US
Practice Address - Phone:928-412-1433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-13
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty