Healthcare Provider Details

I. General information

NPI: 1609689132
Provider Name (Legal Business Name): ROSARLEM S MEJIAS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2025
Last Update Date: 05/17/2025
Certification Date: 05/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 W WOODWARD AVE
EUSTIS FL
32726-4554
US

IV. Provider business mailing address

15673 SE 92ND AVE
SUMMERFIELD FL
34491-5627
US

V. Phone/Fax

Practice location:
  • Phone: 352-357-3565
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11036661
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: