MEDICARE: JOSE LUIS AMADOR MEJIAS ARNP

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	207Q00000X	Family Medicine Physician	11035790	FL

General Provider Information

NPI Number	:	1861211773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE LUIS AMADOR MEJIAS ARNP

Provider Business Mailing Address
First Line	:	2110 ROOKERY BAY DR APT 3002
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34114-9374
Country	:	US
Telephone Number	:	832-266-4721
Fax Number	:

Provider Business Practice Location Address
First Line	:	2110 ROOKERY BAY DR APT 3002
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34114-9374
Country	:	US
Telephone Number	:	832-266-4721
Fax Number	:

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

Provider Enumeration Date	:	10/08/2024
Last Update Date	:	10/08/2024

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