Individual
MAYDEN BORREGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1800 SW 69TH AVE, PLANTATION, FL 33317-5027
(305) 496-1904
Mailing address
1800 SW 69TH AVE, PLANTATION, FL 33317-5027
(305) 496-1904
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC 4502
FL
Other
Enumeration date
09/16/2009
Last updated
09/16/2009
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