Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | 137 | FL |
NPI | 1477029155 |
---|---|
Provider Name | Victoria Elena Mendez |
First Address | Orlando, FL 32812-8206 |
Second Address | Orlando, FL 32812-8206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2018 |
Last Update Date | 19/10/2018 |