Healthcare Provider Details

I. General information

NPI: 1588577688
Provider Name (Legal Business Name): MYRIAM LOUAKED RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 N ORANGE AVE
ORLANDO FL
32804-4603
US

IV. Provider business mailing address

1196 IVY MANOR ST
MINNEOLA FL
34715-8116
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-2422
  • Fax:
Mailing address:
  • Phone: 407-409-1899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberRN9657558
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: