Provider Demographics
NPI:1588117667
Name:GRIMSLEY, ANA CHRISTINA (RDN, LD/N)
Entity type:Individual
Prefix:MRS
First Name:ANA
Middle Name:CHRISTINA
Last Name:GRIMSLEY
Suffix:
Gender:F
Credentials:RDN, LD/N
Other - Prefix:MISS
Other - First Name:ANA
Other - Middle Name:CHRISTINA
Other - Last Name:ALFONSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:6478 MOSELEY ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-4109
Mailing Address - Country:US
Mailing Address - Phone:305-498-0995
Mailing Address - Fax:
Practice Address - Street 1:6478 MOSELEY ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024
Practice Address - Country:US
Practice Address - Phone:305-498-0995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-26
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist