Individual
MARIANELLA MIJARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSFA
Contact information
Practice address
1316 HEARTHSTONE DR, RIDGELAND, SC 29936-7088
(352) 397-7450
Mailing address
PO BOX 1460, HARDEEVILLE, SC 29927-1460
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
180808
—
Other
Enumeration date
06/14/2018
Last updated
06/14/2018
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