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General NPI Number Information
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NPI Number | 1366792905
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Entity Type | Individual
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Provider Name | BIANCA MENESES PA- C
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Gender | Female
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Dates
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Enumeration Date | 09/11/2012
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 3100 CORAL HILLS DR SUITE 305
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-4137
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Country | US
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Telephone | 954-575-8056
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Fax | 954-575-2563
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Provider Business Mailing Address
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Address Line | 3100 CORAL HILLS DR SUITE 305
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-4137
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Country | US
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Telephone | 954-575-8056
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Fax | 954-575-2563
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PAT9106729
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License Number State | FL
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