Provider Demographics
NPI:1245525906
Name:SPROUL, TOYA TMOUR (PBT)
Entity type:Individual
Prefix:MRS
First Name:TOYA
Middle Name:TMOUR
Last Name:SPROUL
Suffix:
Gender:F
Credentials:PBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 RIVERSIDE AVE
Mailing Address - Street 2:UNIT 1010
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32202-4999
Mailing Address - Country:US
Mailing Address - Phone:904-335-8331
Mailing Address - Fax:
Practice Address - Street 1:200 RIVERSIDE AVE
Practice Address - Street 2:UNIT 1010
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32202-4999
Practice Address - Country:US
Practice Address - Phone:904-335-8331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy