Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | ME97438 | FL |
NPI | 1003846494 |
---|---|
Provider Name | Alejandro Mendoza |
First Address | Fort Lauderdale, FL 33309 |
Second Address | Fort Lauderdale, FL 33309 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 14/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009943198 | (05) | AL |
1047481 | (05) | LA |
277232900 | (05) | FL |
E98021 | (02) | LA |
P00397043 | RAILROAD MEDICARE (01) | GA |