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NPI Code Detail

MEDICARE: MR. EDUARDO L MESINA RPT

MEDICARE:  MR. EDUARDO L MESINA  RPT
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
1225100000XPhysical TherapistPT7834FL

General Provider Information

NPI Number : 1881797041
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. EDUARDO L MESINA RPT
Provider Business Mailing Address
First Line : 1325 SAN MARCO BLVD
Second Line : SUITE 200
City : JACKSONVILLE
State : FL
Zip : 32207-8568
Country : US
Telephone Number : 904-346-3465
Fax Number : 904-858-6489
Provider Business Practice Location Address
First Line : 1845 TOWN CENTER BLVD STE 410
Second Line : CREDENTIALING DEPARTMENT
City : FLEMING ISLAND
State : FL
Zip : 32003-3361
Country : US
Telephone Number : 904-621-0396
Fax Number : 904-621-0397
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2006
Last Update Date : 03/18/2015

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Directions to “ MR. EDUARDO L MESINA RPT” Practice Location

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