Healthcare Provider Details

I. General information

NPI: 1437764602
Provider Name (Legal Business Name): LUISA N MENDEZ RMHCI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2020
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5540 NW 101ST CT
DORAL FL
33178-2642
US

IV. Provider business mailing address

5540 NW 101ST CT
DORAL FL
33178-2642
US

V. Phone/Fax

Practice location:
  • Phone: 786-449-9778
  • Fax:
Mailing address:
  • Phone: 786-449-9778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBCBA-1-25-82178
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: