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General NPI Number Information
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NPI Number | 1356542609
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Entity Type | Individual
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Provider Name | MIRIAH BETH DENBO M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 03/03/2022
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Provider Practice Location Address
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Address Line | 515 S. KINGS AVENUE, SUITE 3000
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City | BRANDON
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State | FL
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Zip | 33511-6066
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Country | US
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Telephone | 813-681-6625
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Fax | 813-684-6043
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Provider Business Mailing Address
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Address Line | PO BOX 917770
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City | ORLANDO
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State | FL
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Zip | 32891-0001
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Country | US
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Telephone | 813-821-8038
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Fax | 813-974-4325
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME138771
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License Number State | FL
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