Healthcare Provider Details

I. General information

NPI: 1417753146
Provider Name (Legal Business Name): MENDING HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2025
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MARQUETTE AVE NW STE 1200
ALBUQUERQUE NM
87102-5312
US

IV. Provider business mailing address

6539 W HANNA AVE
TAMPA FL
33634-4961
US

V. Phone/Fax

Practice location:
  • Phone: 505-307-5837
  • Fax: 727-630-2936
Mailing address:
  • Phone: 505-307-5837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: YORDANYS VALDES
Title or Position: APRN/OWNER
Credential: APRN
Phone: 505-307-5837