Provider Demographics
NPI:1104523356
Name:FEOLA, LEYDA MONICA (RDH)
Entity type:Individual
Prefix:MRS
First Name:LEYDA
Middle Name:MONICA
Last Name:FEOLA
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:MRS
Other - First Name:LEYDA
Other - Middle Name:MONICA
Other - Last Name:ZULETA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4661 121ST TER N
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-8921
Mailing Address - Country:US
Mailing Address - Phone:561-317-7235
Mailing Address - Fax:
Practice Address - Street 1:39200 HOOKER HWY
Practice Address - Street 2:
Practice Address - City:BELLE GLADE
Practice Address - State:FL
Practice Address - Zip Code:33430-5368
Practice Address - Country:US
Practice Address - Phone:561-642-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH16643124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist