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1013115120
MARIO HEREDIA
ALTAMONTE SPRINGS, FL
NPI
1013115120
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Former Name
MARIO ALFREDO HEREDIA BLANCO
Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: FL PA9108764)
Enumeration Date
2007-07-10
Last Update Date
2016-05-05
Business Address
-- MARIO HEREDIA PA-C
711 E ALTAMONTE DR STE 210
ALTAMONTE SPRINGS, FL 32701-4824
Phone number: 407-303-5452
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Mailing Address
-- MARIO HEREDIA PA-C
3127 W HALLANDALE BEACH BLVD #102
HALLANDALE, FL 33009-5150
Phone number: 866-816-7846
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