Provider Demographics
NPI:1205375375
Name:FLOYD, FELISHA (BS,CLC,IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:FELISHA
Middle Name:
Last Name:FLOYD
Suffix:
Gender:F
Credentials:BS,CLC,IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 WINSTON AVE
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-7527
Mailing Address - Country:US
Mailing Address - Phone:850-530-4681
Mailing Address - Fax:
Practice Address - Street 1:1819 WINSTON AVE
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566-7527
Practice Address - Country:US
Practice Address - Phone:850-530-4681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL59095174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN