MEDICARE: ANYELEY MESA

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	111NR0400X	Rehabilitation Chiropractor	26-3719220	FL

General Provider Information

NPI Number	:	1730324633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANYELEY MESA

Provider Business Mailing Address
First Line	:	1489 N MILITARY TRL STE 210
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-6057
Country	:	US
Telephone Number	:	561-686-2646
Fax Number	:	561-686-2645

Provider Business Practice Location Address
First Line	:	1489 N MILITARY TRL STE 210
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-6057
Country	:	US
Telephone Number	:	561-686-2646
Fax Number	:	561-686-2645

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

Provider Enumeration Date	:	12/05/2008
Last Update Date	:	12/05/2008

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Directions to “ ANYELEY MESA ” Practice Location

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