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Individual

DR. MOLLY HELEN WEIDNER MANDERNACH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1600 SW ARCHER ROAD, GAINESVILLE, FL 32610
(352) 273-7832
(352) 273-7849
Mailing address
PO BOX 918025, ORLANDO, FL 32891-0001
(352) 273-7832

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME97424
FL
207RH0003X
Hematology & Oncology Physician
Primary
ME97424
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
005939200
FL
Enumeration date
10/17/2006
Last updated
09/17/2012
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