Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 525 | FL |
NPI | 1043547730 |
---|---|
Provider Name | Dr. Lina Maria Mejia |
First Address | Davie, FL 33328-2018 |
Second Address | Davie, FL 33328-2018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2009 |
Last Update Date | 17/11/2009 |