Provider Demographics
NPI:1598578395
Name:SPAULDING, MAI (RDN)
Entity type:Individual
Prefix:
First Name:MAI
Middle Name:
Last Name:SPAULDING
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4766 PASTEL CT
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-2526
Mailing Address - Country:US
Mailing Address - Phone:818-441-6774
Mailing Address - Fax:
Practice Address - Street 1:4766 PASTEL CT
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34240-2526
Practice Address - Country:US
Practice Address - Phone:818-441-6774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13905133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered