Provider Demographics
NPI:1700105392
Name:MEHLA, PRITI
Entity type:Individual
Prefix:DR
First Name:PRITI
Middle Name:
Last Name:MEHLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20084 SE BRIDGEWATER DR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-1651
Mailing Address - Country:US
Mailing Address - Phone:860-899-6773
Mailing Address - Fax:
Practice Address - Street 1:1300 N LAWNWOOD CIR
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-4884
Practice Address - Country:US
Practice Address - Phone:772-302-3977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-22
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FL174560207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program