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General NPI Number Information
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NPI Number | 1538827027
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Entity Type | Individual
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Provider Name | CARMEN BEATRIZ MESA MARTINEZ CBHCMS
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Gender | Female
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Dates
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Enumeration Date | 12/02/2021
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 1463 SW 29TH AVE
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City | FT LAUDERDALE
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State | FL
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Zip | 33312-3817
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Country | US
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Telephone | 954-709-0707
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Fax |
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Provider Business Mailing Address
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Address Line | 1463 SW 29TH AVE
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City | FT LAUDERDALE
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State | FL
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Zip | 33312-3817
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Country | US
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Telephone | 954-709-0707
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | CBHCMS.0102780
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License Number State |
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