Individual
OTTO RENE MEJIA SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
4105 SW 98TH COURT, MIAMI, FL 33165-5154
(305) 229-5090
(305) 229-5090
Mailing address
4105 SW 98 COURT, MIAMI, FL 33165-5154
(305) 229-5050
(305) 229-5090
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP 9253643
FL
Other
Enumeration date
03/31/2011
Last updated
03/31/2011
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