Provider Demographics
NPI:1619340924
Name:MEGDAL, FELICIA (MSW)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:MEGDAL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13800 TECH CITY CIR STE 307
Mailing Address - Street 2:
Mailing Address - City:ALACHUA
Mailing Address - State:FL
Mailing Address - Zip Code:32615-7254
Mailing Address - Country:US
Mailing Address - Phone:714-655-0510
Mailing Address - Fax:
Practice Address - Street 1:13800 TECH CITY CIR STE 307
Practice Address - Street 2:
Practice Address - City:ALACHUA
Practice Address - State:FL
Practice Address - Zip Code:32615-7254
Practice Address - Country:US
Practice Address - Phone:714-655-0510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-09
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN80431041C0700X
CA846721041C0700X
FL214571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical