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NPI Code Detail

MEDICARE: MERLAINE SIVELS MA

MEDICARE: MERLAINE SIVELS MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor19807FL

General Provider Information

NPI Number : 1053907535
Entity Type Code : Individual
Provider Name (Legal Business Name) : MERLAINE SIVELS MA
Provider Business Mailing Address
First Line : 6147 CHRISTIAN WAY
Second Line :
City : ORLANDO
State : FL
Zip : 32808-1435
Country : US
Telephone Number : 407-296-5300
Fax Number :
Provider Business Practice Location Address
First Line : 6147 CHRISTIAN WAY
Second Line :
City : ORLANDO
State : FL
Zip : 32808-1435
Country : US
Telephone Number : 407-296-5300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2020
Last Update Date : 12/18/2020

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Directions to “ MERLAINE SIVELS MA” Practice Location

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