Provider Demographics
NPI:1952582611
Name:MEJIA GARCIA, ALEX VLADIMIR (MD)
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:VLADIMIR
Last Name:MEJIA GARCIA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:ALEX
Other - Middle Name:
Other - Last Name:MEJIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3555 10TH CT STE 200B
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-5013
Mailing Address - Country:US
Mailing Address - Phone:772-563-4673
Mailing Address - Fax:
Practice Address - Street 1:3555 10TH CT STE 200B
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-5013
Practice Address - Country:US
Practice Address - Phone:772-563-4673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-21
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ5038207RH0003X
PAMD432278207R00000X
FLME150873207RH0003X, 207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX348187102OtherCSHCN
TX348187101Medicaid
TX348187102OtherCSHCN