Provider Demographics
NPI:1093324386
Name:MERGLER, SYDNEY M
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:M
Last Name:MERGLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4425 JAMIE CT APT 101
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-3116
Mailing Address - Country:US
Mailing Address - Phone:305-282-0237
Mailing Address - Fax:
Practice Address - Street 1:1818 HARDEN BLVD STE 160
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-1824
Practice Address - Country:US
Practice Address - Phone:863-683-4726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-23
Last Update Date:2024-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1093324386222Q00000X
FLSI44192355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist