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Individual

MARY BETH KANSORA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3880 TAMIAMI TRL N, NAPLES, FL 34103-3504
(239) 659-3937
Mailing address
3880 TAMIAMI TRL N, NAPLES, FL 34103-3504
(239) 659-3937

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
200000480
NC
207W00000X
Ophthalmology Physician
Primary
ME131063
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
093AG
BC/BS PROVIDER NUMBER
NC
05
89093AG
NC
Enumeration date
06/09/2005
Last updated
03/17/2018
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