Healthcare Provider Details

I. General information

NPI: 1154297935
Provider Name (Legal Business Name): JUAN DAVID MEJIA D.C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2025
Last Update Date: 10/24/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23964 TERRACINA CT
LAND O LAKES FL
34639-2840
US

IV. Provider business mailing address

23964 TERRACINA CT
LAND O LAKES FL
34639-2840
US

V. Phone/Fax

Practice location:
  • Phone: 813-475-0223
  • Fax:
Mailing address:
  • Phone: 813-475-0223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number15692
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: