Provider Demographics
NPI:1730392382
Name:BROOKS, REBECCA FITE (MPH, RD, LDN, CSR)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:FITE
Last Name:BROOKS
Suffix:
Gender:F
Credentials:MPH, RD, LDN, CSR
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:FITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:500 MOONLIGHT CT
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34771-9062
Mailing Address - Country:US
Mailing Address - Phone:813-313-7779
Mailing Address - Fax:888-974-1047
Practice Address - Street 1:1154 CELEBRATION BLVD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34747-4605
Practice Address - Country:US
Practice Address - Phone:407-566-1780
Practice Address - Fax:407-566-1756
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND 5113133VN1005X
GALD 2940133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal