Provider Demographics
NPI:1558655589
Name:VERCELES, IRA N
Entity Type:Individual
Prefix:
First Name:IRA
Middle Name:N
Last Name:VERCELES
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 1:11315 CORPORATE BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-8344
Mailing Address - Country:US
Mailing Address - Phone:800-774-7785
Mailing Address - Fax:
Practice Address - Street 1:3355 HOLYOKE DR STE 100
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90065-2718
Practice Address - Country:US
Practice Address - Phone:626-321-5490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist