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Individual

MRS. MELINDA LEE GAITANIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA55295

Contact information

Practice address
490 E HATHAWAY AVE, BRONSON, FL 32621-6736
(352) 486-6899
(352) 486-2974
Mailing address
491 N HATHAWAY AVE, BRONSON, FL 32621-6122
(352) 281-9651
(352) 486-2974

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA55295
FL

Other

Enumeration date
02/03/2009
Last updated
02/03/2009
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