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General NPI Number Information
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NPI Number | 1669920237
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Entity Type | Individual
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Provider Name | MR. MIGUEL MESTRE JR.
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Gender | Male
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Dates
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Enumeration Date | 09/13/2016
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 33044 US HWY 27 N
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City | HAINES CITY
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State | FL
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Zip | 33844-7621
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Country | US
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Telephone | 863-422-4977
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Fax |
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Provider Business Mailing Address
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Address Line | 425 W COLONIAL DR STE 303
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City | ORLANDO
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State | FL
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Zip | 32804-6863
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Country | US
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Telephone | 321-332-6947
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | RN9198073
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9198073
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | ARNP9198073
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | ARNP9198073
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | ARNP9198073
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License Number State | FL
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