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General NPI Number Information
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NPI Number | 1255852893
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Entity Type | Individual
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Provider Name | CASEY MENDEL
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Gender | Female
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Dates
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Enumeration Date | 07/05/2017
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Last Update Date | 07/05/2017
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Provider Practice Location Address
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Address Line | 4000 CENTRAL FLORIDA BLVD
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City | ORLANDO
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State | FL
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Zip | 32816-8005
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Country | US
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Telephone | 407-823-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 5762 WOODMERE LAKE CIR
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City | NAPLES
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State | FL
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Zip | 34112-2744
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Country | US
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Telephone | 239-285-7627
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Fax | 239-285-7627
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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