Provider Demographics
NPI:1568345056
Name:MAILOLLI, JOHNA ZORA (RDN)
Entity type:Individual
Prefix:MISS
First Name:JOHNA
Middle Name:ZORA
Last Name:MAILOLLI
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:MS
Other - First Name:JOHNA
Other - Middle Name:ZORA
Other - Last Name:MAILOLLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:4435 1ST ST NE UNIT 107
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703-4955
Mailing Address - Country:US
Mailing Address - Phone:201-538-4899
Mailing Address - Fax:
Practice Address - Street 1:4435 1ST ST NE UNIT 107
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33703-4955
Practice Address - Country:US
Practice Address - Phone:201-538-4899
Practice Address - Fax:201-538-4899
Is Sole Proprietor?:No
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1043521133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered