Individual
EBONIQUE MAEWEATHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
9500 SATELLITE BLVD, ORLANDO, FL 32837-8464
(407) 859-5656
(407) 859-2124
Mailing address
1109 SW 10TH ST, OCALA, FL 34474-2725
(352) 629-3455
(352) 629-8642
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9100975
FL
Other
Enumeration date
01/19/2007
Last updated
07/08/2007
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