Healthcare Provider Details

I. General information

NPI: 1265958326
Provider Name (Legal Business Name): RONALD ZASHARY MENDEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2017
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1936 DAIRY RD
WEST MELBOURNE FL
32904-4046
US

IV. Provider business mailing address

1936 DAIRY RD
WEST MELBOURNE FL
32904-4046
US

V. Phone/Fax

Practice location:
  • Phone: 321-821-4041
  • Fax: 800-521-7876
Mailing address:
  • Phone: 321-821-4041
  • Fax: 800-521-7876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME148938
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME148938
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: