Healthcare Provider Details

I. General information

NPI: 1679883771
Provider Name (Legal Business Name): JUAN CARLOS MEJIA GARCES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2010
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15532 W COLONIAL DR STE C
WINTER GARDEN FL
34787-9570
US

IV. Provider business mailing address

15532 W COLONIAL DR STE C
WINTER GARDEN FL
34787-9570
US

V. Phone/Fax

Practice location:
  • Phone: 407-554-9200
  • Fax: 407-554-9202
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME138446
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberME138446
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number45711
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: