De Sena, Mary R
De Sena, Mary R is an sole proprietor health care provider with primary practice located at 635 1St St N , Winter Haven FL 33881-4129. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. De Sena, Mary R can be contacted via phone (863) 294-0670.Contact Information
Primary practice address
635 1St St N
Winter Haven FL 33881-4129
Phone: (863) 294-0670
Fax: (863) 298-3200
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ME90242 | Florida |
Profile Details
| NPI number | 1104819853 |
|---|---|
| LBN Legal business name | De Sena, Mary R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 29th, 2005 |
| Last updated | May 29th, 2024 - about 4 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104819853 | NPPES |
| Florida | MEDICAID | 273214900 | |
| Florida | Other | P00606035 |
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