Healthcare Provider Details

I. General information

NPI: 1780978445
Provider Name (Legal Business Name): MERIDIAN ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2011
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

934 N MAGNOLIA AVE STE 327
ORLANDO FL
32803-3840
US

IV. Provider business mailing address

12226 CORPORATE BLVD STE 142
ORLANDO FL
32817-8388
US

V. Phone/Fax

Practice location:
  • Phone: 407-601-3615
  • Fax: 386-200-5919
Mailing address:
  • Phone: 407-601-3615
  • Fax: 386-200-5919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MRS. EVELYN ELIZABETH CLEGG
Title or Position: ADMINISTRATOR
Credential: MSW
Phone: 407-496-2192