Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | DR.0061992 | CO |
N | 208600000X | Surgeon | DR.0061992 | CO |
N | 208200000X | Surgeon | ME149575 | FL |
N | 208600000X | Surgeon | ME149575 | FL |
N | 2086S0102X | Surgical Critical Care | DR.0061992 | CO |
N | 2086S0102X | Surgical Critical Care | ME149575 | FL |
N | 2086S0127X | Trauma Surgeon | DR.0061992 | CO |
Y | 2086S0127X | Trauma Surgeon | ME149575 | FL |
NPI | 1306112586 |
---|---|
Provider Name | Dr. Jonathan P. Meizoso |
First Address | Miami, FL 33136 |
Second Address | Miami, FL 33136-1018 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2012 |
Last Update Date | 04/05/2021 |