Healthcare Provider Details

I. General information

NPI: 1659192599
Provider Name (Legal Business Name): TIFFANY MENDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2024
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10155 DOWDEN RD STE 302
ORLANDO FL
32832-5227
US

IV. Provider business mailing address

10155 DOWDEN RD STE 302
ORLANDO FL
32832-5227
US

V. Phone/Fax

Practice location:
  • Phone: 407-569-1700
  • Fax: 407-569-1701
Mailing address:
  • Phone: 407-569-1700
  • Fax: 407-569-1701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT42226
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: