Mesa, Iliana

Mesa, Iliana is an sole proprietor health care provider with primary practice located at 10650 W State Road 84 Ste 206 , Davie FL 33324-4235. She recently has only one registered license in Nursing Service Related Providers / Personal Care Attendant, which is considered as her primary health care specialty. Mesa, Iliana can be contacted via phone (954) 634-3636.

Contact Information

Primary practice address
10650 W State Road 84 Ste 206 Davie FL 33324-4235
Phone: (954) 634-3636
Fax: (954) 634-3637
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Personal Care Attendant 3747P1801X

Profile Details

NPI number 1629513445
LBN Legal business name Mesa, Iliana
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 3rd, 2017
Last updated Jan 3rd, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629513445 NPPES
Florida MEDICAID 019228600

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