Individual
ANDREA MACIAS MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-1951
(352) 273-8610
(352) 273-8612
Mailing address
PO BOX 100254, GAINESVILLE, FL 32610-0254
(352) 273-8610
(352) 273-8612
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME142622
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107257400
—
FL
Enumeration date
04/14/2016
Last updated
03/03/2021
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