# DOMINIQUE MESIDOR MD P.A.

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

## Provider details

- **NPI number:** 1720113558
- **Authorized official:** DOMINIQUE MESIDOR M.D. (PRESIDENT)
- **Authorized official phone:** (727) 328-7400

## Contact information

- **Practice address:** 1839 CENTRAL AVE, ST PETERSBURG, FL 33713-8900
- **Practice address phone:** (727) 896-1300
- **Practice address fax:** (727) 896-1311
- **Mailing address:** PO BOX 16226, ST PETERSBURG, FL 33733-6226
- **Mailing address phone:** (727) 896-1300
- **Mailing address fax:** (727) 896-1311

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0102X | Surgical Critical Care Physician | ME86398 | FL | Yes |
| 2086S0127X | Trauma Surgery Physician | ME86398 | FL | — |

## Other

- **Enumeration date:** 02/22/2007
- **Last updated:** 02/26/2008