Individual
EDUARDO DANIEL MORENO MANDUJANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2615 N MONROE ST STE 1, TALLAHASSEE, FL 32303-4027
(850) 558-6126
(850) 220-4461
Mailing address
PO BOX 1089, OMEGA, GA 31775-1089
(229) 589-1962
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9115758
FL
Other
Enumeration date
02/13/2021
Last updated
01/26/2025
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