Individual
JAIME HUMBERTO MEMBRENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 PARK PLACE BLVD, STE#202, KISSIMMEE, FL 34741-2332
(407) 931-1510
(407) 931-3759
Mailing address
100 PARK PLACE BLVD, STE#202, KISSIMMEE, FL 34741-2332
(407) 931-1510
(407) 931-3759
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
ME85244
FL
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
ME85244
FL
Other
Enumeration date
03/10/2006
Last updated
04/12/2017
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