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General NPI Number Information
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NPI Number | 1083895536
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Entity Type | Individual
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Provider Name | CARLOS J MEZA-VALENCIA
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Gender | Male
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Dates
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Enumeration Date | 11/26/2007
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Last Update Date | 03/27/2020
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Provider Practice Location Address
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Address Line | 936 SW 1ST AVE STE 838
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City | MIAMI
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State | FL
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Zip | 33130-4520
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Country | US
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Telephone | 571-244-4684
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Fax | 888-356-1032
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Provider Business Mailing Address
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Address Line | 936 SW 1ST AVE STE 838
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City | MIAMI
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State | FL
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Zip | 33130-4520
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Country | US
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Telephone | 571-244-4684
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Fax | 888-356-1032
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State | FL
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