Healthcare Provider Details

I. General information

NPI: 1588348312
Provider Name (Legal Business Name): CARMEL MEZIER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2023
Last Update Date: 06/12/2023
Certification Date: 06/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1188 LAKE VICTORIA DR APT K
WEST PALM BEACH FL
33411-9340
US

IV. Provider business mailing address

1188 LAKE VICTORIA DR APT K
WEST PALM BEACH FL
33411-9340
US

V. Phone/Fax

Practice location:
  • Phone: 561-629-0664
  • Fax:
Mailing address:
  • Phone: 561-629-0664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberL21000394967
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: