MEDICARE: JESSICA MENDEZ

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	2355S0801X	Speech-Language Assistant

General Provider Information

NPI Number	:	1982463949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA MENDEZ

Provider Business Mailing Address
First Line	:	3549 ALAFAYA PALMS DR UNIT 305
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828-7853
Country	:	US
Telephone Number	:	407-234-7039
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 S WEST CROWN POINT RD STE 150
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-2917
Country	:	US
Telephone Number	:	407-491-3825
Fax Number	:

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

Provider Enumeration Date	:	03/13/2024
Last Update Date	:	03/13/2024

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Directions to “ JESSICA MENDEZ ” Practice Location

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