Provider Demographics
NPI:1720846264
Name:SOLIZ, KIMBERLY D (RDN)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:D
Last Name:SOLIZ
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 SIMPSON AVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC HIGHLANDS
Mailing Address - State:NJ
Mailing Address - Zip Code:07716-1638
Mailing Address - Country:US
Mailing Address - Phone:512-743-2336
Mailing Address - Fax:
Practice Address - Street 1:12 SIMPSON AVENUE
Practice Address - Street 2:
Practice Address - City:ATLANTIC HIGHLANDS
Practice Address - State:NJ
Practice Address - Zip Code:07716-3459
Practice Address - Country:US
Practice Address - Phone:512-743-2336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ86156995133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered