Provider Demographics
NPI:1679254262
Name:MEKHAIL, MINA WAGIH
Entity type:Individual
Prefix:
First Name:MINA
Middle Name:WAGIH
Last Name:MEKHAIL
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 1:25429 GEDDY DR
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34639-5670
Mailing Address - Country:US
Mailing Address - Phone:813-407-8663
Mailing Address - Fax:
Practice Address - Street 1:25429 GEDDY DR
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34639-5670
Practice Address - Country:US
Practice Address - Phone:813-407-8663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator