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General NPI Number Information
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NPI Number | 1104120351
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Entity Type | Organization
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Legal Business Name | LEONARDO MENDEZ MD PC
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Dates
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Enumeration Date | 01/03/2011
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Last Update Date | 01/03/2011
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Provider Practice Location Address
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Address Line | 1635 N GEORGE MASON DR SUITE 470
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City | ARLINGTON
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State | VA
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Zip | 22205-3601
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Country | US
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Telephone | 703-522-9090
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Fax | 703-522-9096
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Provider Business Mailing Address
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Address Line | 1635 N GEORGE MASON DR SUITE 470
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City | ARLINGTON
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State | VA
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Zip | 22205-3601
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Country | US
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Telephone | 703-522-9090
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Fax | 703-522-9096
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LEONARDO MENDEZ
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Credential | M.D.
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Telephone | 703-522-9090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 0101052239
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License Number State | VA
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