Provider Demographics
NPI:1245205087
Name:MEESIT, MARIA VENTURA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:VENTURA
Last Name:MEESIT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:THERESA
Other - Last Name:VENTURA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4801 SWIFT RD
Mailing Address - Street 2:SUITE I
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-5139
Mailing Address - Country:US
Mailing Address - Phone:941-927-3770
Mailing Address - Fax:941-921-8330
Practice Address - Street 1:4801 SWIFT RD
Practice Address - Street 2:SUITE I
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-5139
Practice Address - Country:US
Practice Address - Phone:941-927-3770
Practice Address - Fax:941-921-8330
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 6219111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4352328OtherAETNA PROVIDER #
FL4352328OtherAETNA PROVIDER #
FL22535Medicare ID - Type UnspecifiedMEDICARE/BCBS PROVIDER #