Individual
DIVYA MENON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1824 KING ST STE 300, JACKSONVILLE, FL 32204
(904) 388-1820
(904) 388-1827
Mailing address
1507 S HIAWASSEE RD, STE 107, ORLANDO, FL 32835-5706
(407) 445-9545
(407) 445-9365
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9107224
FL
Other
Enumeration date
07/09/2013
Last updated
05/12/2020
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