Individual
MS. MAYA GENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
8913 US HIGHWAY 301 N, PARRISH, FL 34219-8701
(941) 776-3921
Mailing address
805 69TH AVE W, BRADENTON, FL 34207-6170
(941) 266-7466
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MA42609
FL
Other
Enumeration date
05/10/2007
Last updated
07/08/2007
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