Healthcare Provider Details

I. General information

NPI: 1497168108
Provider Name (Legal Business Name): MINNI MEKA M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MINNI MEKA MD

II. Dates (important events)

Enumeration Date: 06/10/2014
Last Update Date: 03/23/2023
Certification Date: 03/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10101 FOREST HILL BLVD, WELLINGTON
WELLINGTON FL
33414-6103
US

IV. Provider business mailing address

4344 HOOKS RD APT 527
LAKE WORTH FL
33467-3704
US

V. Phone/Fax

Practice location:
  • Phone: 561-798-8504
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: