Provider Demographics
NPI:1689853707
Name:MEJIA, RAUL C (MD)
Entity Type:Individual
Prefix:
First Name:RAUL
Middle Name:C
Last Name:MEJIA
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 1:1411 NO FLAGLER DRIVE
Mailing Address - Street 2:SUITE 5600
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401
Mailing Address - Country:US
Mailing Address - Phone:561-832-3176
Mailing Address - Fax:561-694-8688
Practice Address - Street 1:1411 NO FLAGLER DRIVE
Practice Address - Street 2:SUITE 5600
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401
Practice Address - Country:US
Practice Address - Phone:561-832-3176
Practice Address - Fax:561-694-8688
Is Sole Proprietor?:No
Enumeration Date:2007-10-25
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program