1194080721

Everything you always wanted to know about DR. LEBLANC ANA CONSUELO MD 1 DR. MAYORAL ANA CONSUELO MD but were afraid to ask.

DR. LEBLANC ANA CONSUELO MD 1 DR. MAYORAL ANA CONSUELO MD

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Provider Prefix Provider Last Name Provider Middle Name Provider First Name Provider Credential Provider Other Name Type Code Provider Other Name Prefix Provider Other Last Name Provider Other Middle Name Provider Other First Name Provider Other Credential
DR. LEBLANC ANA CONSUELO MD 1 DR. MAYORAL ANA CONSUELO MD
Gender:
Female
Enumeration date:
2012-07-10
Last update date:
2012-07-10
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
No
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Identifiers

identifier description issuer state

Taxonomies

Taxonomy State License Number Primary?
208000000X Pediatrics MA 212970 Y

Phone Numbers

Type Number
Mailing Address Telephone Number 502458601838
Practice Location Address Telephone Number 50245860138

Addresses

Type Address City State Postal Country
Mailing Address 4A AVENIDA, 5-6, LOCAL A, CAJA #19, AGENCIA POSTAL TERCERA AV. SAN LUCAS SACATEPEQUEZ 0 SACATEPEQUEZ
Practice Location Address VIVERO MARIA FELISA- CUATRO CAMINOS SAN LUCAS SACATEPEQUEZ 0 SACATEPEQUEZ