Healthcare Provider Details

I. General information

NPI: 1730187287
Provider Name (Legal Business Name): LUIS E. MENDEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 06/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 UNIVERSITY DR SUITE 3300
CORAL GABLES FL
33146-2008
US

IV. Provider business mailing address

5000 UNIVERSITY DR SUITE 3300
CORAL GABLES FL
33146-2008
US

V. Phone/Fax

Practice location:
  • Phone: 305-663-7001
  • Fax: 305-663-7004
Mailing address:
  • Phone: 305-663-7001
  • Fax: 305-663-7004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberME0069610
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: