MEDICARE: MAYA MENDONSA

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1598606709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAYA MENDONSA

Provider Business Mailing Address
First Line	:	4118 MOSER LN
Second Line	:
City	:	PERRYSBURG
State	:	OH
Zip	:	43551-7183
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	231 ALBERT SABIN WAY
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45267-0558
Country	:	US
Telephone Number	:	513-558-4206
Fax Number	:

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

Provider Enumeration Date	:	04/02/2026
Last Update Date	:	04/02/2026

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Directions to “ MAYA MENDONSA ” Practice Location

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