Provider Demographics
NPI:1730324633
Name:MESA, ANYELEY
Entity Type:Individual
Prefix:
First Name:ANYELEY
Middle Name:
Last Name:MESA
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 1:1489 N MILITARY TRL STE 210
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-6057
Mailing Address - Country:US
Mailing Address - Phone:561-686-2646
Mailing Address - Fax:561-686-2645
Practice Address - Street 1:1489 N MILITARY TRL STE 210
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-6057
Practice Address - Country:US
Practice Address - Phone:561-686-2646
Practice Address - Fax:561-686-2645
Is Sole Proprietor?:No
Enumeration Date:2008-12-05
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL26-3719220111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation