Provider Demographics
NPI:1881797041
Name:MESINA, EDUARDO L (RPT)
Entity type:Individual
Prefix:MR
First Name:EDUARDO
Middle Name:L
Last Name:MESINA
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Gender:M
Credentials:RPT
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Mailing Address - Street 1:1325 SAN MARCO BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-8568
Mailing Address - Country:US
Mailing Address - Phone:904-346-3465
Mailing Address - Fax:904-858-6489
Practice Address - Street 1:1845 TOWN CENTER BLVD STE 410
Practice Address - Street 2:CREDENTIALING DEPARTMENT
Practice Address - City:FLEMING ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32003-3361
Practice Address - Country:US
Practice Address - Phone:904-621-0396
Practice Address - Fax:904-621-0397
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2015-03-18
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Provider Licenses
StateLicense IDTaxonomies
FLPT7834225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCX768ZMedicare PIN