Individual
VICTORIA MAYNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1314 OAK ST, MELBOURNE, FL 32901-3111
(321) 727-7992
Mailing address
1314 OAK ST, MELBOURNE, FL 32901-3111
(321) 727-7992
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9115829
FL
Other
Enumeration date
05/03/2022
Last updated
01/13/2025
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