NPIMap

Waiki Vicky Cora, RD

Individual provider Active NPI Registered Dietitian · Tampa, FL

NPI 1356513865 · NPPES record last updated Feb 28, 2024

Key facts

NPI
1356513865
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
ND10389 (FL)
Practice address
8270 Woodland Center Blvd
Tampa, FL 33614-2401
Phone
(305) 449-9219
Fax
(515) 864-0259
NPI assigned
Mar 25, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
ND10389FLMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X ND10389 FL Yes
Registered Dietitian 133V00000X LD1583 NM

Addresses

Primary practice location

8270 Woodland Center Blvd
Tampa, FL 33614-2401

Mailing address

317 6TH Ave Ste 400
Des Moines, IA 50309-4108

Other practice location 1

735 W Animas St
Farmington, NM 87401-5616
Phone (505) 609-6300

Other identifiers

IdentifierTypeStateIssuer
933602OtherHICDR CERTIFICATION

Other names

  • Waiki Vicky Leung Former name

Other providers in Tampa, FL

All providers in Tampa, FL · Registered Dietitian in Florida

Sources for this page

Verify at the official NPI Registry.