Individual
ALEXANDRA M MIENTUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
571 S FLOYD ST STE 412, LOUISVILLE, KY 40202-3877
(502) 629-8828
Mailing address
571 S FLOYD ST STE 412, LOUISVILLE, KY 40202-3877
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
56812
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2019
Last updated
11/15/2022
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