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General NPI Number Information
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NPI Number | 1487502878
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Entity Type | Individual
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Provider Name | THAIMARA MENDEZ PENA
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Gender | Female
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Dates
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Enumeration Date | 03/20/2026
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Last Update Date | 03/20/2026
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Provider Practice Location Address
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Address Line | 2001 NW 107TH AVE STE 412
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City | DORAL
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State | FL
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Zip | 33172-2514
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Country | US
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Telephone | 786-548-8322
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Fax | 305-356-7932
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Provider Business Mailing Address
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Address Line | 2001 NW 107TH AVE STE 412
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City | DORAL
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State | FL
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Zip | 33172-2514
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Country | US
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Telephone | 786-548-8322
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Fax | 305-356-7932
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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