Provider Demographics
NPI:1164212130
Name:CABAN RODRIGUEZ, ANGELICA M (RD, LDN)
Entity type:Individual
Prefix:
First Name:ANGELICA
Middle Name:M
Last Name:CABAN RODRIGUEZ
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8050 BAYMEADOWS CIR W APT 4108
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-5508
Mailing Address - Country:US
Mailing Address - Phone:954-743-7246
Mailing Address - Fax:
Practice Address - Street 1:8050 BAYMEADOWS CIR W APT 4108
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-5508
Practice Address - Country:US
Practice Address - Phone:954-743-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered