Active NPI
Jennifer Lee Mesa
- Speech-Language Pathologist
- Miramar, FL
National Provider Identifier
1942500558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SZ5130
- Practice address
- 17906 SW 29TH St
Miramar, FL 33029-5155 - Phone
- (954) 258-2560
- Fax
- (954) 438-6539
- NPI assigned
- Oct 28, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SZ5130 | FL | Primary |
Addresses
Primary practice location
17906 SW 29TH St
Miramar, FL 33029-5155
Mailing address
17906 SW 29TH St
Miramar, FL 33029-5155
Phone (954) 258-2560
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
| License | State | Type | Specialty |
|---|---|---|---|
| SZ5130 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288310400000",
"number": "1942500558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17906 SW 29TH ST",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330295155",
"telephone_number": "954-258-2560",
"fax_number": "954-438-6539"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17906 SW 29TH ST",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330295155",
"telephone_number": "954-258-2560",
"fax_number": "954-438-6539"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MESA",
"first_name": "JENNIFER",
"middle_name": "LEE",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-10-28",
"last_updated": "2010-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SZ5130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miramar, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.