Healthcare Provider Details

I. General information

NPI: 1598628810
Provider Name (Legal Business Name): YAHAIRA MATIAS MENDEZ FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2131 MARYLAND AVE
BALTIMORE MD
21218-5614
US

IV. Provider business mailing address

12010 BONITA AVE
OWINGS MILLS MD
21117-1202
US

V. Phone/Fax

Practice location:
  • Phone: 443-762-5343
  • Fax: 833-258-3941
Mailing address:
  • Phone: 443-500-2134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR209001
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: