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Individual

MARK A. MINTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
507 DEL PRADO BOULEVARD, CAPE CORAL, FL 33990
(239) 772-0500
(239) 772-3076
Mailing address
2234 COLONIAL BLVD, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME0031596
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
038588300
FL
01
1193412
WELLCARE
FL
01
1262065-010
CIGNA PROVIDER NUMBER
FL
01
202216
AMERIGROUP PROVIDER NUM.
FL
01
256184
USA MNGD. CR. PROVIDER #
FL
01
277536
AVMED PROVIDER NUMBER
FL
01
4197070
AETNA PROVIDER NUMBER
FL
01
68175
OP. ENGIN. PROVIDER #
FL
01
709333
FIRST HLTH/CCN PROVIDER #
FL
01
79302
BCBS PROVIDER NUMBER
FL
01
ME0031596
METCARE PROVIDER NUMBER
FL
Enumeration date
02/21/2006
Last updated
04/26/2016
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