MEDICARE: YENELY MESA OTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	23948	FL

General Provider Information

NPI Number	:	1427442128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YENELY MESA OTR

Provider Business Mailing Address
First Line	:	3635 SW 91ST AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-4360
Country	:	US
Telephone Number	:	786-246-4606
Fax Number	:

Provider Business Practice Location Address
First Line	:	3635 SW 91ST AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-4360
Country	:	US
Telephone Number	:	786-246-4606
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2015
Last Update Date	:	06/01/2026

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