Malliany Camejo Leonor, | |
11921 Saradrienne Ln, Bonita Springs, FL 34135-5911 | |
(393) 442-3532 | |
(239) 992-4984 |
Full Name | Malliany Camejo Leonor |
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Gender | Female |
Speciality | Pediatrics |
Location | 11921 Saradrienne Ln, Bonita Springs, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1952823379 | NPI | - | NPPES |
MN964 | Other | FL | MEDICARE |
106651300 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | ME145242 (Florida) | Primary |
Entity Name | Family Health Centers Of Southwest Florida Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1326090390 PECOS PAC ID: 3173432085 Enrollment ID: O20040106000084 |
Mailing Address | Practice Location Address |
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Malliany Camejo Leonor, Po Box 919771, Orlando, FL 32891-9771 Ph: (239) 278-3600 | Malliany Camejo Leonor, 11921 Saradrienne Ln, Bonita Springs, FL 34135-5911 Ph: (393) 442-3532 |
Maria Carolina Rico, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 11921 Saradrienne Ln, Bonita Springs, FL 34135 Phone: 239-344-2353 Fax: 239-992-4984 | |
Michel E Saaloukeh, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 9400 Bonita Beach Rd Se Ste 204, Bonita Springs, FL 34135 Phone: 239-422-6020 | |
Dr. Hugo Perez, M.D. F.A.A.P. Pediatrics Medicare: Medicare Enrolled Practice Location: 9200 Bonita Beach Rd Se Ste 106, Bonita Springs, FL 34135 Phone: 239-213-0690 Fax: 239-552-4060 | |
Dr. Bernard Hal Feldman, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 26455 S Tamiami Trl, Suite 4201, Bonita Springs, FL 34134 Phone: 239-494-1352 | |
Ms. Athina Lynn Kyritsis, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 25243 Elementary Way, Suite 103, Bonita Springs, FL 34135 Phone: 239-498-9114 Fax: 239-498-6555 |