Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | ME93023 | FL |
NPI | 1427144542 |
---|---|
Provider Name | Dr. Fernando G Mendoza |
First Address | Coral Gables, FL 33146-2737 |
Second Address | Miami, FL 33176 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 08/07/2007 |