Individual provider Active NPI

Yoslaine Tereza Mesa-Jimenez

  • Psychologist
  • Fort Lauderdale, FL
National Provider Identifier
1548840671
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY11021 Issued in FL
Practice address
2425 E Commercial Blvd Ste 405
Fort Lauderdale, FL 33308-4029
Phone
(754) 400-5514
NPI assigned
Apr 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY11021 FL Primary

Addresses

Primary practice location

2425 E Commercial Blvd Ste 405
Fort Lauderdale, FL 33308-4029

Mailing address

1000 Jefferson St Ste 2C
Lynchburg, VA 24504-1724

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY11021FLMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1548840671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 JEFFERSON ST STE 2C",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245041724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 E COMMERCIAL BLVD STE 405",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084029",
            "telephone_number": "754-400-5514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESA-JIMENEZ",
        "first_name": "YOSLAINE",
        "middle_name": "TEREZA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY11021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.