Healthcare Provider Details

I. General information

NPI: 1952114464
Provider Name (Legal Business Name): MEL LOUTFI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2025
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 SAND LAKE RD STE 266
ORLANDO FL
32809-7748
US

IV. Provider business mailing address

7811 SATSUMA CT
ORLANDO FL
32835-5316
US

V. Phone/Fax

Practice location:
  • Phone: 321-445-1287
  • Fax:
Mailing address:
  • Phone: 407-308-8393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number7706
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: