Provider Demographics
NPI:1639344559
Name:MESA, ARCENIO ERNESTO (MSOTR/L)
Entity Type:Individual
Prefix:MR
First Name:ARCENIO
Middle Name:ERNESTO
Last Name:MESA
Suffix:
Gender:M
Credentials:MSOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6891 GREENE ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-2833
Mailing Address - Country:US
Mailing Address - Phone:954-655-5872
Mailing Address - Fax:
Practice Address - Street 1:1000 WEST AVE
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-4759
Practice Address - Country:US
Practice Address - Phone:305-778-9198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 13167225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist