Healthcare Provider Details

I. General information

NPI: 1023057080
Provider Name (Legal Business Name): SOUTH FLORIDA GERIATRICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16470 NE 10TH AVE
NORTH MIAMI BEACH FL
33162-3710
US

IV. Provider business mailing address

16470 NE 10TH AVE
NORTH MIAMI BEACH FL
33162-3710
US

V. Phone/Fax

Practice location:
  • Phone: 305-651-5825
  • Fax: 305-652-4733
Mailing address:
  • Phone: 305-651-5825
  • Fax: 305-652-4733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOAQUIN MENDEZ
Title or Position: OWNER/PRESIDENT
Credential: MD
Phone: 305-651-5825