Provider Demographics
NPI:1710798988
Name:SCHIMKA, ANGELA MARIE (RD, LDN)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:SCHIMKA
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 1:1242 SE 24TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-1966
Mailing Address - Country:US
Mailing Address - Phone:239-383-8616
Mailing Address - Fax:
Practice Address - Street 1:1242 SE 24TH AVE
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-1966
Practice Address - Country:US
Practice Address - Phone:239-383-8616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND10573133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered