Provider Demographics
NPI:1750938346
Name:SAVINON, CARLA MARIE (RDN)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:MARIE
Last Name:SAVINON
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:CARLA
Other - Middle Name:MARIE
Other - Last Name:ADCOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:805 NESTLEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-2536
Mailing Address - Country:US
Mailing Address - Phone:910-528-2812
Mailing Address - Fax:
Practice Address - Street 1:805 NESTLEWOOD CT
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2536
Practice Address - Country:US
Practice Address - Phone:910-528-2812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND8683133VN1005X, 133VN1004X, 133VN1006X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic