Healthcare Provider Details

I. General information

NPI: 1558314690
Provider Name (Legal Business Name): ERNESTO MEYER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 08/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 CORBETT ST STE 210
BELLEAIR FL
33756-7302
US

IV. Provider business mailing address

401 CORBETT ST STE 210
BELLEAIR FL
33756-7302
US

V. Phone/Fax

Practice location:
  • Phone: 727-446-1161
  • Fax: 727-446-8212
Mailing address:
  • Phone: 727-446-1161
  • Fax: 727-446-8212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME74440
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: