Individual
DR. MARY MAGNO MOURACADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7981 GLADIOLUS DR, FT MYERS, FL 33908-4154
(239) 939-0999
Mailing address
7981 GLADIOLUS DR, FT MYERS, FL 33908-4154
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME65887
FL
207RA0401X
Addiction Medicine (Internal Medicine) Physician
ME65887
FL
207RN0300X
Nephrology Physician
Primary
ME65887
FL
Other
Enumeration date
05/15/2006
Last updated
03/12/2024
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