Organization
MAXINE MINTO MD P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAXINE JOAN MINTO M.D. (PRESIDENT)
(407) 536-5375
Entity
Organization
Contact information
Practice address
1540 INTERNATIONAL PKWY, SUITE 2000, LAKE MARY, FL 32746-4713
(407) 536-5375
(407) 536-5301
Mailing address
10524 MOSS PARK RD, SUITE 204-516, ORLANDO, FL 32832-5898
(407) 536-5375
(407) 536-5301
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
ME69898
FL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
ME69898
FL
Other
Enumeration date
10/12/2011
Last updated
10/13/2011
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