Provider Demographics
NPI:1962374496
Name:LETA, PATRICIA ANN (RD/LDN)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:LETA
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 1:1820 SOMMARIE WAY APT 322
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-6206
Mailing Address - Country:US
Mailing Address - Phone:914-462-2205
Mailing Address - Fax:
Practice Address - Street 1:1820 SOMMARIE WAY
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-6206
Practice Address - Country:US
Practice Address - Phone:914-462-2205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND7547133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered