MEDICARE: JOHN ARISTEDES MEKRAS M.D.,P.H.D.

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	208800000X	Urology Physician	ME0061974	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	15056	OTHER	FL	BLUE CROSS AND BLUE SHIEL
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457457681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN ARISTEDES MEKRAS M.D.,P.H.D.

Provider Business Mailing Address
First Line	:	7051 SW 62ND AVE
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-4701
Country	:	US
Telephone Number	:	305-661-8977
Fax Number	:	305-662-9123

Provider Business Practice Location Address
First Line	:	7051 SW 62ND AVE
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-4701
Country	:	US
Telephone Number	:	305-661-8977
Fax Number	:	305-662-9123

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

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	11/24/2010

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