Provider Demographics
NPI:1558314690
Name:MEYER, ERNESTO (MD)
Entity Type:Individual
Prefix:
First Name:ERNESTO
Middle Name:
Last Name:MEYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 CORBETT ST STE 210
Mailing Address - Street 2:
Mailing Address - City:BELLEAIR
Mailing Address - State:FL
Mailing Address - Zip Code:33756-7302
Mailing Address - Country:US
Mailing Address - Phone:727-446-1161
Mailing Address - Fax:727-446-8212
Practice Address - Street 1:401 CORBETT ST STE 210
Practice Address - Street 2:
Practice Address - City:BELLEAIR
Practice Address - State:FL
Practice Address - Zip Code:33756-7302
Practice Address - Country:US
Practice Address - Phone:727-446-1161
Practice Address - Fax:727-446-8212
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME74440208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics