MEDICARE: MS. IANA LEEANN PARKER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251V00000X	Voluntary or Charitable Agency		FL

General Provider Information

NPI Number	:	1194495564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. IANA LEEANN PARKER

Provider Business Mailing Address
First Line	:	51 LAFAYETTE ST
Second Line	:
City	:	CHICOPEE
State	:	MA
Zip	:	01020-1505
Country	:	US
Telephone Number	:	413-221-7544
Fax Number	:

Provider Business Practice Location Address
First Line	:	16900 N BAY RD
Second Line	:
City	:	SUNNY ISLES BEACH
State	:	FL
Zip	:	33160-4252
Country	:	US
Telephone Number	:	413-221-7544
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2021
Last Update Date	:	09/11/2025

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