Most Relevant Information
Provider Data
| NPI Number: | 1003329863 |
| Provider Name: | ISLENA LUCETH KEYES RD, LD |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 39306-DI-0 |
Most Important Dates
| Enumeration Date: | 11/14/2017 |
| Last Updated: | 12/05/2019 |
Provider Practice Location
13000 BRUCE B DOWNS BLVD
TAMPA
FL
33612
Practice Location Phone/Fax
| Phone: | 8139722000 |
| Fax: |
Provider Mailing Location
13000 BRUCE B DOWNS BLVD
TAMPA
FL
336124745
Provider Mailing Phone/Fax
| Phone: | 8139722000 |
| Fax: |