MEDICARE: DR. DIANA E MENDEZ MD

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	207R00000X	Internal Medicine Physician	13197	PR
2	207R00000X	Internal Medicine Physician	ACN178	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801852439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DIANA E MENDEZ MD

Provider Business Mailing Address
First Line	:	6101 BLUE LAGOON DR STE 400
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-2051
Country	:	US
Telephone Number	:	305-500-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	4090 S RIDGEWOOD AVE
Second Line	:
City	:	PT ORANGE
State	:	FL
Zip	:	32127-4501
Country	:	US
Telephone Number	:	386-761-0050
Fax Number	:	386-761-1167

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

Provider Enumeration Date	:	04/22/2006
Last Update Date	:	08/14/2024

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Directions to “ DR. DIANA E MENDEZ MD” Practice Location

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