| Maxine Minto Md P.a. | |
|
1540 International Pkwy Suite 2000 Lake Mary FL 32746-4713 | |
| (407) 536-5375 | |
| (407) 536-5301 |
| Full Name | Maxine Minto Md P.a. |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 1540 International Pkwy, Lake Mary, Florida |
| Authorized Official Name and Position | Maxine Joan Minto (PRESIDENT) |
| Authorized Official Contact | 4075365375 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maxine Minto Md P.a. 10524 Moss Park Rd Suite 204-516 Orlando FL 32832-5898 Ph: (407) 536-5375 | Maxine Minto Md P.a. 1540 International Pkwy Suite 2000 Lake Mary FL 32746-4713 Ph: (407) 536-5375 |
| NPI Number | 1376828178 |
|---|---|
| Provider Enumeration Date | 10/12/2011 |
| Last Update Date | 10/13/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376828178 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | ME69898 (Florida) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | ME69898 (Florida) | Primary |
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