Provider Demographics
NPI:1710683610
Name:MEZIDOR, JOKEBEDE
Entity Type:Individual
Prefix:
First Name:JOKEBEDE
Middle Name:
Last Name:MEZIDOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 ALPHA ST
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-6802
Mailing Address - Country:US
Mailing Address - Phone:561-603-0295
Mailing Address - Fax:
Practice Address - Street 1:1220 ALPHA ST
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-6802
Practice Address - Country:US
Practice Address - Phone:561-603-0295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula