Healthcare Provider Details

I. General information

NPI: 1588590228
Provider Name (Legal Business Name): MEILY DE LAS MERCEDES DIAZ SORIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2414 RUSH BAY WAY
ORLANDO FL
32824-4517
US

IV. Provider business mailing address

2414 RUSH BAY WAY
ORLANDO FL
32824-4517
US

V. Phone/Fax

Practice location:
  • Phone: 407-470-6888
  • Fax:
Mailing address:
  • Phone: 407-470-6888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: