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Organization
GIL EMMANUEL A MEJIA MD PA
Active
Organization
GIL EMMANUEL A MEJIA MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VINA MEJIA BEECH (HEALTH SERVICE MANAGER)
(813) 960-3436
Entity
Organization
Contact information
Practice address
4102 W LINEBAUGH AVE, STE 100, TAMPA, FL 33624-5296
(813) 960-3436
(813) 960-3735
Mailing address
4102 W LINEBAUGH AVE, STE 100, TAMPA, FL 33624-5296
(813) 960-3436
(813) 960-3735
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2244015
AETNA
FL
01
—
255428
AVMED
FL
05
—
256054200
—
FL
01
—
369744
WELLCARE
FL
01
—
44247
BCBS
FL
01
—
AD169
PTAN
FL
Enumeration date
06/28/2007
Last updated
11/20/2009
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