Healthcare Provider Details
I. General information
NPI: 1750737417
Provider Name (Legal Business Name): MISS MARIA MEKETA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/11/2016
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3620 JONQUIL LN
WINTER PARK FL
32792-6220
US
IV. Provider business mailing address
3620 JONQUIL LN
WINTER PARK FL
32792-6220
US
V. Phone/Fax
- Phone: 518-253-8571
- Fax:
- Phone: 518-253-8571
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | C010158 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | SW13096 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: