Provider Demographics
NPI:1699087585
Name:SHIELA LOYOLA
Entity type:Organization
Organization Name:SHIELA LOYOLA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RPT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHIELA
Authorized Official - Middle Name:EDAYA
Authorized Official - Last Name:LOYOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1818-310-2525
Mailing Address - Street 1:5900 WEST SAMPLE ROAD
Mailing Address - Street 2:UNIT 101
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067
Mailing Address - Country:US
Mailing Address - Phone:181-831-0252
Mailing Address - Fax:
Practice Address - Street 1:5900 W SAMPLE RD
Practice Address - Street 2:UNIT 304
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-3248
Practice Address - Country:US
Practice Address - Phone:181-831-0252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070017759314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility