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General NPI Number Information
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NPI Number | 1679573638
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Entity Type | Individual
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Provider Name | JOSE G MEJIA MD
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Gender | Male
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Dates
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Enumeration Date | 07/29/2005
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 1133 SEMINOLE DR
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City | ROCKLEDGE
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State | FL
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Zip | 32955-2836
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Country | US
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Telephone | 321-637-2975
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Fax | 321-433-1935
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Provider Business Mailing Address
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Address Line | 1133 SEMINOLE DR
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City | ROCKLEDGE
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State | FL
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Zip | 32955-2836
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Country | US
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Telephone | 321-637-2975
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Fax | 321-433-1935
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 58297
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME81630
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License Number State | FL
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