Provider Information for 1508487497
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LORENA MEJIA
Sex: Female
NPI: 1508487497
Last Updated: 2020-05-01
Certification Date: 2020-05-01
Certification Date: 2020-05-01
Details
| Name | Value | ||||||||||||||||||||||||||||
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| NPI | 1508487497 | ||||||||||||||||||||||||||||
| Enumeration Date | 2020-05-01 | ||||||||||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||||||||||||||
| Status | Active | ||||||||||||||||||||||||||||
| Mailing Address | 1250 NE 209TH TER MIAMI, FL 33179-2025 United States Phone: 786-288-9880 | Fax: | ||||||||||||||||||||||||||||
| Primary Practice Address | 1250 NE 209TH TER MIAMI, FL 33179-2025 United States Phone: 786-288-9880 | Fax: | ||||||||||||||||||||||||||||
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