Provider Demographics
NPI:1780763565
Name:MEJIA, JAIME (MD)
Entity type:Individual
Prefix:MR
First Name:JAIME
Middle Name:
Last Name:MEJIA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:5920 JOHNSON ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-5652
Mailing Address - Country:US
Mailing Address - Phone:954-894-6022
Mailing Address - Fax:954-894-6023
Practice Address - Street 1:5920 JOHNSON ST
Practice Address - Street 2:SUITE 104
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5652
Practice Address - Country:US
Practice Address - Phone:954-894-6022
Practice Address - Fax:954-894-6023
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2008-09-26
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Provider Licenses
StateLicense IDTaxonomies
FLME662792085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology