Healthcare Provider Details

I. General information

NPI: 1679112601
Provider Name (Legal Business Name): LAURA HERNANDEZ MENDEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2019
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 SOUTH DIXIE HIGHWAY SUITE 202
JUPITER FL
33458
US

IV. Provider business mailing address

1495 FOREST HILL BLVD STE A1
WEST PALM BEACH FL
33406-6073
US

V. Phone/Fax

Practice location:
  • Phone: 786-560-8559
  • Fax:
Mailing address:
  • Phone: 786-560-8559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-19-98360
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: