Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | ME53534 | FL |
Y | 2080P0204X | Pediatric Emergency Doctor | ME53534 | FL |
NPI | 1073558367 |
---|---|
Provider Name | Francisco Medina Mejia |
First Address | Tampa, FL 33655-0001 |
Second Address | Miami, FL 33176-2118 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2006 |
Last Update Date | 18/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F87792 | (02) | FL |