MEDICARE: JOSE LUIS MESA LABRADA

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	101YM0800X	Mental Health Counselor	MH27711	FL
2	103K00000X	Behavior Analyst	1-21-49290

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871051607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE LUIS MESA LABRADA

Provider Business Mailing Address
First Line	:	1000 BRICKELL AVE STE 1100
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33131-3014
Country	:	US
Telephone Number	:	305-562-6072
Fax Number	:	305-747-7310

Provider Business Practice Location Address
First Line	:	1000 BRICKELL AVE STE 1100
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33131-3014
Country	:	US
Telephone Number	:	305-562-6072
Fax Number	:	305-747-7310

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

Provider Enumeration Date	:	03/11/2019
Last Update Date	:	05/14/2026

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