# INTERVENTIONAL NEUROLOGY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417165101
- **Authorized official:** ANTONIO MESA D.O. (DOCTOR)
- **Authorized official phone:** (305) 670-7650

## Contact information

- **Practice address:** 11880 SW 40TH ST, SUITE 18, MIAMI, FL 33175-3574
- **Practice address phone:** (305) 670-7650
- **Practice address fax:** (305) 670-7657
- **Mailing address:** PO BOX 43-1405, SOUTH MIAMI, FL 33243-1405
- **Mailing address phone:** (305) 670-7650
- **Mailing address fax:** (305) 670-7657

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084N0400X | Neurology Physician | OS8711 | FL | — |
| 2084P2900X | Pain Medicine (Psychiatry & Neurology) Physician | OS8711 | FL | Yes |

## Other

- **Enumeration date:** 05/18/2007
- **Last updated:** 10/27/2007