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General NPI Number Information
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NPI Number | 1003414640
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Entity Type | Individual
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Provider Name | ADYANA RAQUEL MEJIAS DE LEON
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Gender | Female
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Dates
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Enumeration Date | 10/15/2020
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Last Update Date | 10/15/2020
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Provider Practice Location Address
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Address Line | 5800 GOLF CLUB PKWY
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City | ORLANDO
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State | FL
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Zip | 32808-4800
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Country | US
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Telephone | 407-904-0134
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Fax |
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Provider Business Mailing Address
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Address Line | 1020 ABERNATHY LN APT 306
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City | APOPKA
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State | FL
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Zip | 32703-8693
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Country | US
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Telephone | 787-235-6002
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | SI3614
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License Number State | FL
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