Provider Demographics
NPI:1386062305
Name:MESA, ADRIAN L (DNP, PMHNP-BC, FNP)
Entity type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:L
Last Name:MESA
Suffix:
Gender:
Credentials:DNP, PMHNP-BC, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 SW 22ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-2876
Mailing Address - Country:US
Mailing Address - Phone:305-204-9355
Mailing Address - Fax:305-640-8034
Practice Address - Street 1:1411 SW 22ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2876
Practice Address - Country:US
Practice Address - Phone:305-204-9355
Practice Address - Fax:305-640-8034
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-07
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9250921363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104322000Medicaid
FL108891900Medicaid