Provider Demographics
NPI:1508152422
Name:MEJIA, ALVARO (ARNP)
Entity Type:Individual
Prefix:
First Name:ALVARO
Middle Name:
Last Name:MEJIA
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19251 GULFSTREAM RD
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-7807
Mailing Address - Country:US
Mailing Address - Phone:786-229-3234
Mailing Address - Fax:
Practice Address - Street 1:8600 NW 17TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33126-1039
Practice Address - Country:US
Practice Address - Phone:305-470-5660
Practice Address - Fax:305-470-5533
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9214811363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily