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Individual
DR. RENE N MAYORGA
Active
Individual
DR. RENE N MAYORGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME 54068
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08688
BLUE CROSS BLUE SHIEL
FL
01
—
2132789
AETNA
—
Enumeration date
11/20/2006
Last updated
10/25/2010
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