Maxine Minto MD P.a.

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

License

ME69898 Issued in FL

Legal business name

MAXINE MINTO MD P.A.

Practice address

1540 International Pkwy
Suite 2000
Lake Mary, FL 32746-4713

Phone

(407) 536-5375

Fax

(407) 536-5301

NPI assigned

Oct 12, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Maxine Joan Minto, M.D.

Title

President

Phone

(407) 536-5375

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318464000000",
    "number": "1376828178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10524 MOSS PARK RD",
            "address_2": "SUITE 204-516",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328325898",
            "telephone_number": "407-536-5375",
            "fax_number": "407-536-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 INTERNATIONAL PKWY",
            "address_2": "SUITE 2000",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327464713",
            "telephone_number": "407-536-5375",
            "fax_number": "407-536-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXINE MINTO MD P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-12",
        "last_updated": "2011-10-13",
        "status": "A",
        "authorized_official_last_name": "MINTO",
        "authorized_official_first_name": "MAXINE",
        "authorized_official_middle_name": "JOAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-536-5375",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "FL",
            "license": "ME69898",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "FL",
            "license": "ME69898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Matos, NP
• Deane Gail Matthew, MA, LMHC
• Tiffany R Matthews, LMT
• John Mauriello, M.D.
• Ciara Maxfield
• Heather May, LMHC
• Ivan Dario Maya, MD
• Lloyd Javarr Mayes III
• Sara Mazariegos
• Mackenzy Alexis McAbee

• Adolescent and Children Mental Health Clinic/Center in Lake Mary, FL
• Providers in Lake Mary, FL by specialty
• Adolescent and Children Mental Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.