Provider Demographics
NPI:1871259838
Name:PAYTON, MICHA
Entity type:Individual
Prefix:
First Name:MICHA
Middle Name:
Last Name:PAYTON
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 1:1737 MESSINA AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-4832
Mailing Address - Country:US
Mailing Address - Phone:321-362-2531
Mailing Address - Fax:
Practice Address - Street 1:1737 MESSINA AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811-4832
Practice Address - Country:US
Practice Address - Phone:321-362-2531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-15
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide