Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 0750 | AZ |
NPI | 1083840318 |
---|---|
Provider Name | Dr. Mia Melillo Horvath |
First Address | Mesa, AZ 85204-6655 |
Second Address | Mesa, AZ 85204-6655 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2009 |
Last Update Date | 28/02/2013 |