Provider Demographics
NPI:1972870384
Name:MENCO, MILTON M (PA-C)
Entity type:Individual
Prefix:MR
First Name:MILTON
Middle Name:M
Last Name:MENCO
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:1600 S FEDERAL HWY
Mailing Address - Street 2:TENTH FLOOR
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-7500
Mailing Address - Country:US
Mailing Address - Phone:954-788-9000
Mailing Address - Fax:954-783-1951
Practice Address - Street 1:1600 S FEDERAL HWY
Practice Address - Street 2:TENTH FLOOR
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-7500
Practice Address - Country:US
Practice Address - Phone:954-788-9000
Practice Address - Fax:954-783-1951
Is Sole Proprietor?:No
Enumeration Date:2011-11-30
Last Update Date:2011-11-30
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Provider Licenses
StateLicense IDTaxonomies
FLPA9105759363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant