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General NPI Number Information
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NPI Number | 1124138607
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Entity Type | Individual
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Provider Name | HERBERT MENDELSOHN MD
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 106 BOSTON AVE STE 105
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-4711
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Country | US
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Telephone | 407-834-9091
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Fax | 407-834-6157
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Provider Business Mailing Address
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Address Line | 2600 LAKE LUCIEN DR STE 180
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City | MAITLAND
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State | FL
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Zip | 32751-7235
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Country | US
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Telephone | 407-875-2080
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Fax | 407-875-0518
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | ME19484
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License Number State | FL
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