Individual
DR. MEENA DEMETRIOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4203 BELFORT RD STE 204, JACKSONVILLE, FL 32216-1463
(904) 296-5688
(904) 296-5699
Mailing address
4205 BELFORT RD STE 4015, JACKSONVILLE, FL 32216-3623
(904) 450-6017
(904) 450-6041
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
077782
GA
207V00000X
Obstetrics & Gynecology Physician
Primary
ME146669
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08117262
AMERIGROUP
GA
05
—
107709000
—
FL
Enumeration date
07/02/2012
Last updated
12/09/2021
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