Provider Demographics
NPI:1275240269
Name:MERCED, OMAYRA
Entity Type:Individual
Prefix:
First Name:OMAYRA
Middle Name:
Last Name:MERCED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 E MONUMENT AVE UNIT 303
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-5772
Mailing Address - Country:US
Mailing Address - Phone:407-861-8666
Mailing Address - Fax:
Practice Address - Street 1:111 E MONUMENT AVE UNIT 303
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-5772
Practice Address - Country:US
Practice Address - Phone:407-861-8666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion