Healthcare Provider Details

I. General information

NPI: 1609308949
Provider Name (Legal Business Name): JESSICA GISELLE MEJIAS ARNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2017
Last Update Date: 03/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 MARSHALL FARMS RD
OCOEE FL
34761-3316
US

IV. Provider business mailing address

801 MARSHALL FARMS RD
OCOEE FL
34761-3316
US

V. Phone/Fax

Practice location:
  • Phone: 407-877-6280
  • Fax: 407-877-8423
Mailing address:
  • Phone: 407-877-6280
  • Fax: 407-877-8423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9282829
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: