Provider Demographics
NPI:1912560632
Name:MCLEOD, LA-SHERIA R
Entity Type:Individual
Prefix:
First Name:LA-SHERIA
Middle Name:R
Last Name:MCLEOD
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 1:3240 SW 34TH ST APT 908
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474
Mailing Address - Country:US
Mailing Address - Phone:352-682-6459
Mailing Address - Fax:352-456-7853
Practice Address - Street 1:3240 SW 34TH ST APT 908
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474
Practice Address - Country:US
Practice Address - Phone:352-682-6459
Practice Address - Fax:352-456-7853
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251C00000X
FLPN5156865164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No251C00000XAgenciesDay Training, Developmentally Disabled Services