Provider Demographics
NPI:1811009020
Name:MEKAS, JEAN G (ARNP)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:G
Last Name:MEKAS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33916-2205
Mailing Address - Country:US
Mailing Address - Phone:239-656-2536
Mailing Address - Fax:239-656-2555
Practice Address - Street 1:3920 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33916-2205
Practice Address - Country:US
Practice Address - Phone:239-656-2536
Practice Address - Fax:239-656-2555
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2077132363LW0102X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL033697100Medicaid