Healthcare Provider Details

I. General information

NPI: 1508152422
Provider Name (Legal Business Name): ALVARO MEJIA ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2011
Last Update Date: 06/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8600 NW 17TH ST SUITE 200
DORAL FL
33126-1039
US

IV. Provider business mailing address

19251 GULFSTREAM RD
CUTLER BAY FL
33157-7807
US

V. Phone/Fax

Practice location:
  • Phone: 305-470-5660
  • Fax: 305-470-5533
Mailing address:
  • Phone: 786-229-3234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP 9214811
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: