Provider Demographics
NPI:1144613266
Name:MEZA, CHRISTIAN (CRNA)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:
Last Name:MEZA
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5755 NW 115TH CT APT 107
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-3825
Mailing Address - Country:US
Mailing Address - Phone:305-794-0394
Mailing Address - Fax:
Practice Address - Street 1:5755 NW 115TH CT APT 107
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-3825
Practice Address - Country:US
Practice Address - Phone:305-794-0394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-13
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9278624367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered