Individual
WALVER BAEZ MEJIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1005 N LAKE PARKER AVE, LAKELAND, FL 33805-4723
(863) 583-4053
Mailing address
152 TRAVIS LN, DAVENPORT, FL 33837-8455
(787) 405-8776
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
1578
FL
208D00000X
General Practice Physician
23123
PR
208D00000X
General Practice Physician
Primary
ACN1578
FL
Other
Enumeration date
03/01/2023
Last updated
01/03/2024
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