Individual provider Active NPI

Otto Rene Mejia Sr., ARNP

  • Adult Health Nurse Practitioner
  • Miami, FL
National Provider Identifier
1457640351
Registry record updated Mar 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP 9253643 Issued in FL
Practice address
4105 SW 98TH Court
Miami, FL 33165-5154
Phone
(305) 229-5090
Fax
(305) 229-5090
NPI assigned
Mar 31, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X ARNP 9253643 FL Primary

Addresses

Primary practice location

4105 SW 98TH Court
Miami, FL 33165-5154

Mailing address

4105 SW 98 Court
Miami, FL 33165-5154
Phone (305) 229-5050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ARNP 9253643FLMDAdult Health Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301529600000",
    "number": "1457640351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 SW 98 COURT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331655154",
            "telephone_number": "305-229-5050",
            "fax_number": "305-229-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 SW 98TH COURT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331655154",
            "telephone_number": "305-229-5090",
            "fax_number": "305-229-5090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEJIA",
        "first_name": "OTTO",
        "middle_name": "RENE",
        "name_suffix": "Sr.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-31",
        "last_updated": "2011-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP 9253643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.