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General NPI Number Information
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NPI Number | 1669790903
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Entity Type | Organization
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Legal Business Name | MESA SPINAL CARE, PA
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Dates
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Enumeration Date | 05/11/2010
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Last Update Date | 05/11/2010
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Provider Practice Location Address
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Address Line | 9600 SW 8TH ST SUITE 23 B
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City | MIAMI
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State | FL
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Zip | 33174-2900
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Country | US
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Telephone | 786-200-1632
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Fax |
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Provider Business Mailing Address
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Address Line | 14241 SW 38TH ST
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City | MIAMI
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State | FL
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Zip | 33175-7806
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Country | US
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Telephone | 786-200-1632
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. DAVID MESA
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Credential | D.C.
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Telephone | 786-200-1632
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH9931
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License Number State | FL
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