Provider Demographics
NPI:1538419056
Name:MENDEZ, DONNA OVIS (LPN)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:OVIS
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16350 BRUCE B DOWNS BLVD UNIT 46532
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33646-9023
Mailing Address - Country:US
Mailing Address - Phone:305-834-0583
Mailing Address - Fax:
Practice Address - Street 1:16350 BRUCE B DOWNS BLVD UNIT 46532
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33646-9023
Practice Address - Country:US
Practice Address - Phone:305-834-0583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-12
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5160720164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5160720OtherLPN