Provider Demographics
NPI:1649169095
Name:MESA, JAIME ALEJANDRO (MBBS)
Entity type:Individual
Prefix:DR
First Name:JAIME
Middle Name:ALEJANDRO
Last Name:MESA
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4233 LONGMOUR LN
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34947-1346
Mailing Address - Country:US
Mailing Address - Phone:754-715-9970
Mailing Address - Fax:
Practice Address - Street 1:4233 LONGMOUR LN
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34947-1346
Practice Address - Country:US
Practice Address - Phone:754-715-9970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No171400000XOther Service ProvidersHealth & Wellness Coach
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program