Provider Demographics
NPI:1972283307
Name:MEJIA, DANIEL
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:MEJIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6421 N FLORIDA AVE
Mailing Address - Street 2:SUITE D-1458
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-6007
Mailing Address - Country:US
Mailing Address - Phone:813-938-0719
Mailing Address - Fax:
Practice Address - Street 1:6421 N FLORIDA AVE
Practice Address - Street 2:SUITE D-1458
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-6007
Practice Address - Country:US
Practice Address - Phone:813-938-0719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-20
Last Update Date:2025-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician