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General NPI Number Information
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NPI Number | 1003175308
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Entity Type | Organization
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Legal Business Name | EFRAIN MENDEZ, MD PA
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Dates
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Enumeration Date | 05/08/2012
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Last Update Date | 05/08/2012
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Provider Practice Location Address
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Address Line | 1601 N PALM AVE SUITE 110A
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-3200
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Country | US
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Telephone | 954-399-8422
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Fax | 954-399-8001
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Provider Business Mailing Address
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Address Line | 1601 N PALM AVE SUITE 110A
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-3200
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Country | US
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Telephone | 954-399-8422
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Fax | 954-399-8001
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Authorized Official
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Title or Position | OWNER
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Name | DR. EFRAIN MENDEZ
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Credential | MD
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Telephone | 954-399-8422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 99003
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License Number State | FL
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