Provider Demographics
NPI:1679212856
Name:GREGORY, LATOYA SHARNETT (MBA, HCM)
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:SHARNETT
Last Name:GREGORY
Suffix:
Gender:F
Credentials:MBA, HCM
Other - Prefix:
Other - First Name:LATOYA
Other - Middle Name:SHARNETT
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1070 N LIBBY CT
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117-4587
Mailing Address - Country:US
Mailing Address - Phone:386-295-7780
Mailing Address - Fax:
Practice Address - Street 1:1070 N LIBBY CT
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-4587
Practice Address - Country:US
Practice Address - Phone:386-295-7780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-03
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)