Provider Demographics
NPI: | 1922785724 |
---|---|
Name: | MEJIA, CARLOS (RRT) |
Entity Type: | Individual |
Prefix: | |
First Name: | CARLOS |
Middle Name: | |
Last Name: | MEJIA |
Suffix: | |
Gender: | M |
Credentials: | RRT |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 1720 FRUITLAND DR |
Mailing Address - Street 2: | |
Mailing Address - City: | DELTONA |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 32725-4594 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 407-970-9424 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1720 FRUITLAND DR |
Practice Address - Street 2: | |
Practice Address - City: | DELTONA |
Practice Address - State: | FL |
Practice Address - Zip Code: | 32725-4594 |
Practice Address - Country: | US |
Practice Address - Phone: | 407-970-9424 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2023-07-03 |
Last Update Date: | 2023-07-03 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 227900000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | |
No | 2279E1000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Educational |
No | 2279G1100X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | General Care |
No | 2279P1004X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Pulmonary Diagnostics |
No | 2279P1006X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Pulmonary Function Technologist |