MARIO HEREDIA

ALTAMONTE SPRINGS, FL
NPI1013115120
Former NameMARIO ALFREDO HEREDIA BLANCO
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: FL  PA9108764)
Enumeration Date2007-07-10
Last Update Date2016-05-05
Business Address
MARIO HEREDIA PA-C
711 E ALTAMONTE DR STE 210
ALTAMONTE SPRINGS, FL 32701-4824
Phone number: 407-303-5452
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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