Individual
MALLIANY CAMEJO LEONOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11921 SARADRIENNE LN, BONITA SPRINGS, FL 34135-5911
(393) 442-3532
(239) 992-4984
Mailing address
PO BOX 919771, ORLANDO, FL 32891-9771
(239) 278-3600
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME145242
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106651300
—
FL
01
—
MN964
MEDICARE
FL
Enumeration date
07/07/2017
Last updated
08/17/2021
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