Mesa Medical Llc | |
1870 Forest Hill Blvd West Palm Beach FL 33406-6057 | |
(561) 766-2373 | |
(561) 766-2615 |
Full Name | Mesa Medical Llc |
---|---|
Speciality | Internal Medicine |
Location | 1870 Forest Hill Blvd, West Palm Beach, Florida |
Authorized Official Name and Position | Angel R Mesa (DOCTOR) |
Authorized Official Contact | 5617662373 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Mesa Medical Llc 1870 Forest Hill Blvd Ste 101 West Palm Beach FL 33406-6057 Ph: (561) 766-2373 | Mesa Medical Llc 1870 Forest Hill Blvd West Palm Beach FL 33406-6057 Ph: (561) 766-2373 |
NPI Number | 1477967511 |
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Provider Enumeration Date | 06/17/2014 |
Last Update Date | 06/17/2014 |
Medicare PECOS PAC ID | 6103143557 |
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Medicare Enrollment ID | O20150323001971 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477967511 | NPI | - | NPPES |
279227300 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | ME99661 (Florida) | Primary |
Provider Name | Angel R Mesa |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1477761898 PECOS PAC ID: 1254426604 Enrollment ID: I20071001000589 |
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