Healthcare Provider Details

I. General information

NPI: 1689628026
Provider Name (Legal Business Name): MERY J LOSSADA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 02/17/2020
Certification Date: 02/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3231 SW 34TH AVE
OCALA FL
34474-8489
US

IV. Provider business mailing address

PO BOX 4860
OCALA FL
34478-4860
US

V. Phone/Fax

Practice location:
  • Phone: 352-873-7400
  • Fax: 352-873-7435
Mailing address:
  • Phone: 352-873-7400
  • Fax: 352-873-7435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084H0002X
TaxonomyHospice and Palliative Medicine (Psychiatry & Neurology) Physician
License NumberME81160
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME81160
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME81160
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberME81160
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: