Provider Demographics
NPI:1538670583
Name:FERGUSON, VIOLA J
Entity Type:Individual
Prefix:MS
First Name:VIOLA
Middle Name:J
Last Name:FERGUSON
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 1:5104 N ORANGE BLOSSOM TRL STE 210
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-1016
Mailing Address - Country:US
Mailing Address - Phone:321-662-9016
Mailing Address - Fax:
Practice Address - Street 1:5104 N ORANGE BLOSSOM TRL STE 210
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-1016
Practice Address - Country:US
Practice Address - Phone:321-662-9016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-17
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator