Provider Demographics
NPI:1639852874
Name:RAY, MYRIAM SHERLY (APRN)
Entity Type:Individual
Prefix:
First Name:MYRIAM
Middle Name:SHERLY
Last Name:RAY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 TREE MEADOW LOOP
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-6619
Mailing Address - Country:US
Mailing Address - Phone:386-801-1084
Mailing Address - Fax:
Practice Address - Street 1:2700 TREE MEADOW LOOP
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-6619
Practice Address - Country:US
Practice Address - Phone:386-801-1084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11028015363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner