Healthcare Provider Details

I. General information

NPI: 1952582611
Provider Name (Legal Business Name): ALEX VLADIMIR MEJIA GARCIA M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ALEX MEJIA

II. Dates (important events)

Enumeration Date: 11/21/2007
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3555 10TH CT STE 200B
VERO BEACH FL
32960-5013
US

IV. Provider business mailing address

3555 10TH CT STE 200B
VERO BEACH FL
32960-5013
US

V. Phone/Fax

Practice location:
  • Phone: 772-563-4673
  • Fax:
Mailing address:
  • Phone: 772-563-4673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberQ5038
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD432278
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberME150873
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberME150873
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: