MEDICARE: GLENDYS GUERRA MENDEZ APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN11018608	FL
2	363L00000X	Nurse Practitioner	APRN11018608	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447909221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLENDYS GUERRA MENDEZ APRN

Provider Business Mailing Address
First Line	:	12171 SW 268TH ST
Second Line	:
City	:	HOMESTEAD
State	:	FL
Zip	:	33032-8001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4401 EMERSON ST STE 8
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-4954
Country	:	US
Telephone Number	:	904-344-0517
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2022
Last Update Date	:	08/22/2025

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