Provider Demographics
NPI:1770171951
Name:MENDEZ, MARIA YSABEL (ARNP)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:YSABEL
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12040 SW 168TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-2149
Mailing Address - Country:US
Mailing Address - Phone:786-282-8501
Mailing Address - Fax:
Practice Address - Street 1:12040 SW 168TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-2149
Practice Address - Country:US
Practice Address - Phone:786-282-8501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9481870163W00000X
FL11009251363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse