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General NPI Number Information
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NPI Number | 1255293924
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Entity Type | Organization
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Legal Business Name | MESK MEDICAL SPA LLC MESK MEDICAL CENTER
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 3440 MARINATOWN LN
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City | NORTH FORT MYERS
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State | FL
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Zip | 33903-7049
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Country | US
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Telephone | 786-614-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 3440 MARINATOWN LN
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City | NORTH FORT MYERS
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State | FL
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Zip | 33903-7049
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CLENIA GUERRA
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Credential | APRN
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Telephone | 786-614-4400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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