Individual
KAY MEKADENAUMPORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
5058 S CONWAY RD, ORLANDO, FL 32812-1258
(407) 851-2790
Mailing address
5058 S CONWAY RD, ORLANDO, FL 32812-1258
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9106817
FL
Other
Enumeration date
09/28/2012
Last updated
09/28/2012
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