Individual
MRS. CAROL JEAN MECCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5950 SW 21ST AVENUE RD, OCALA, FL 34471-0145
(352) 804-9286
Mailing address
5950 SW 21ST AVENUE RD, OCALA, FL 34471-0145
(352) 804-9286
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9106110
FL
363AM0700X
Medical Physician Assistant
Primary
PA9106110
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023098
NCCPA CERTIFICATION
FL
01
—
PA9106110
STATE LICENSE
FL
Enumeration date
09/18/2019
Last updated
06/22/2023
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