Provider Demographics
NPI:1700642915
Name:TOALA, MERIDA (LE)
Entity Type:Individual
Prefix:
First Name:MERIDA
Middle Name:
Last Name:TOALA
Suffix:
Gender:F
Credentials:LE
Other - Prefix:
Other - First Name:MERIDA
Other - Middle Name:
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LE
Mailing Address - Street 1:2245 SILVER PINES PL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808-4418
Mailing Address - Country:US
Mailing Address - Phone:407-476-3125
Mailing Address - Fax:
Practice Address - Street 1:600 PALM SPRINGS DR
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-7870
Practice Address - Country:US
Practice Address - Phone:407-775-2630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFB9796132225500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistGroup - Single Specialty