MEDICARE: CARLOS J MEZA-VALENCIA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant		FL

General Provider Information

NPI Number	:	1083895536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS J MEZA-VALENCIA

Provider Business Mailing Address
First Line	:	936 SW 1ST AVE STE 838
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33130-4520
Country	:	US
Telephone Number	:	571-244-4684
Fax Number	:	888-356-1032

Provider Business Practice Location Address
First Line	:	936 SW 1ST AVE STE 838
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33130-4520
Country	:	US
Telephone Number	:	571-244-4684
Fax Number	:	888-356-1032

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/26/2007
Last Update Date	:	03/27/2020

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Directions to “ CARLOS J MEZA-VALENCIA ” Practice Location

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