Individual
DR. THAIS ODALIS QUELIZ PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
83 W MILLER ST, ORLANDO, FL 32806-2031
(321) 843-9792
Mailing address
1483 LAKE BALDWIN LN, B, ORLANDO, FL 32814-6744
(646) 321-6200
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
ME115985
FL
Other
Enumeration date
01/18/2013
Last updated
06/23/2016
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