=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023741444
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LUIS E MENDEZ LUACES DNP, APRN, PMHNP-BC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/04/2022
-----------------------------------------------------
Last Update Date | 02/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 330 SW 27TH AVE STE 701
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33135-2968
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-363-1880
-----------------------------------------------------
Fax | 786-590-1629
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 330 SW 27TH AVE STE 701
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33135-2968
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-363-1880
-----------------------------------------------------
Fax | 786-590-1629
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 11020419
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 11020419
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------