Provider Demographics
NPI:1659426971
Name:MERY J LOSSADA MD PA
Entity Type:Organization
Organization Name:MERY J LOSSADA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MERY
Authorized Official - Middle Name:J
Authorized Official - Last Name:LOSSADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-861-2314
Mailing Address - Street 1:4600 SW 46TH CT STE 230
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-5786
Mailing Address - Country:US
Mailing Address - Phone:352-861-2314
Mailing Address - Fax:352-861-2574
Practice Address - Street 1:4600 SW 46TH CT STE 230
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-5786
Practice Address - Country:US
Practice Address - Phone:352-861-2314
Practice Address - Fax:352-861-2574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME811602084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK7375Medicare ID - Type Unspecified