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Organization

MARIA M MENA MD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARIA MAGDALENA MENA MD (OWNER)
(352) 435-7772
Entity
Organization

Contact information

Practice address
401 E NORTH BLVD, SUITE 101, LEESBURG, FL 34748-5262
(352) 435-7772
Mailing address
401 E NORTH BLVD, SUITE 101, LEESBURG, FL 34748-5262
(352) 435-7772

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
007161200
FL
Enumeration date
01/15/2013
Last updated
01/15/2013
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