Individual
LADY C BAEZ PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SA-C, P.A
Contact information
Practice address
3134 LANDINGS CIR APT 112, ORLANDO, FL 32824-0015
(850) 556-5073
Mailing address
3134 LANDINGS CIR APT 112, ORLANDO, FL 32824-0015
(850) 556-5073
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
24-279
FL
363A00000X
Physician Assistant
1663-P.A.
PR
Other
Enumeration date
05/22/2023
Last updated
05/12/2024
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