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General NPI Number Information
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NPI Number | 1033920558
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Entity Type | Individual
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Provider Name | MIKAELA MENDEZ PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/15/2025
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Last Update Date | 12/24/2025
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Provider Practice Location Address
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Address Line | 7777 DAVIE ROAD EXT STE 100B
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City | HOLLYWOOD
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State | FL
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Zip | 33024-2524
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Country | US
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Telephone | 954-362-3426
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Fax |
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Provider Business Mailing Address
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Address Line | 714 NE 10TH ST APT 308
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-2524
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Country | US
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Telephone | 954-600-1184
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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