Provider Demographics
NPI:1366792905
Name:MENESES, BIANCA (PA- C)
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:
Last Name:MENESES
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Gender:F
Credentials:PA- C
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3100 CORAL HILLS DR
Mailing Address - Street 2:SUITE 305
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4137
Mailing Address - Country:US
Mailing Address - Phone:954-575-8056
Mailing Address - Fax:954-575-2563
Practice Address - Street 1:3100 CORAL HILLS DR
Practice Address - Street 2:SUITE 305
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4137
Practice Address - Country:US
Practice Address - Phone:954-575-8056
Practice Address - Fax:954-575-2563
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2024-06-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPAT9106729363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical