Individual
MS. MARDI JANE BISHOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1319 S INTERNATIONAL PKWY, SUITE 1151, LAKE MARY, FL 32746-1408
(407) 333-1616
(407) 333-1617
Mailing address
841 LAKEWORTH CIR, LAKE MARY, FL 32746-5346
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME94808
FL
207VX0000X
Obstetrics Physician
01054596A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274559300
—
FL
01
—
37022
BCBS FL
FL
Enumeration date
09/20/2005
Last updated
03/25/2010
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