Individual
MARIAM MERAYO GODO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
4921 STATE ROAD 674, WIMAUMA, FL 33598-3534
(813) 819-3254
Mailing address
11810 THICKET WOOD DR, RIVERVIEW, FL 33579-4306
(502) 533-1821
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
10953
KY
122300000X
Dentist
Primary
DN28735
FL
Other
Enumeration date
05/09/2023
Last updated
01/30/2024
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