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Individual

ANNE MACKENZIE MORTENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
51 PENNSYLVANIA ST, ORLANDO, FL 32806-2937
(321) 843-3220
(321) 843-3210
Mailing address
51 PENNSYLVANIA ST, ORLANDO, FL 32806-2937
(321) 843-3220
(321) 843-3210

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301067210
MI
208000000X
Pediatrics Physician
Primary
ME165327
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
120531200
FL
05
4234723-10
MI
Enumeration date
06/02/2006
Last updated
01/03/2024
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