Provider Demographics
NPI:1477393460
Name:MEJIA & CORREA LLC
Entity type:Organization
Organization Name:MEJIA & CORREA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:MIGUEL
Authorized Official - Last Name:MEJIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-790-4190
Mailing Address - Street 1:1600 S FEDERAL HWY STE 210
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-7500
Mailing Address - Country:US
Mailing Address - Phone:954-790-4190
Mailing Address - Fax:
Practice Address - Street 1:1600 S FEDERAL HWY STE 210
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-7500
Practice Address - Country:US
Practice Address - Phone:954-790-4190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-28
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care