MEDICARE: KEYEYA SANICE FLOYD CNP

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	363LF0000X	Family Nurse Practitioner	024009	OH

General Provider Information

NPI Number	:	1811461015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEYEYA SANICE FLOYD CNP

Provider Business Mailing Address
First Line	:	15925 HOLMES AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44110-2402
Country	:	US
Telephone Number	:	216-374-5202
Fax Number	:

Provider Business Practice Location Address
First Line	:	1756 SAGAMORE RD
Second Line	:
City	:	MACEDONIA
State	:	OH
Zip	:	44067-1086
Country	:	US
Telephone Number	:	330-467-7131
Fax Number	:

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

Provider Enumeration Date	:	01/22/2019
Last Update Date	:	01/22/2019

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