MEDICARE: MEREDITH MESQUITA

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	235Z00000X	Speech-Language Pathologist	126326	AK

General Provider Information

NPI Number	:	1619487972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEREDITH MESQUITA

Provider Business Mailing Address
First Line	:	13001 SUMMER CIR
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99516-2630
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4141 B ST STE 202
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99503-5940
Country	:	US
Telephone Number	:	907-764-8094
Fax Number	:	844-579-0084

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

Provider Enumeration Date	:	10/02/2017
Last Update Date	:	09/18/2024

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Directions to “ MEREDITH MESQUITA ” Practice Location

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