Provider Demographics
NPI:1558708172
Name:MERINO, DAYSI MERCEDES
Entity Type:Individual
Prefix:MS
First Name:DAYSI
Middle Name:MERCEDES
Last Name:MERINO
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 1:1510 DINGENS AVE
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-8000
Mailing Address - Country:US
Mailing Address - Phone:407-295-8872
Mailing Address - Fax:407-295-8872
Practice Address - Street 1:1510 DINGENS AVE
Practice Address - Street 2:
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-8000
Practice Address - Country:US
Practice Address - Phone:407-295-8872
Practice Address - Fax:407-295-8872
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-23
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6906391311ZA0620X
FL13713310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL114622200Medicaid