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General NPI Number Information
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NPI Number | 1568461622
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Entity Type | Individual
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Provider Name | CARLOS A MENDEZ MD
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Gender | Male
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Dates
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Enumeration Date | 07/20/2005
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Last Update Date | 06/18/2021
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Provider Practice Location Address
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Address Line | 802 40TH ST W
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City | BRADENTON
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State | FL
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Zip | 34205-1724
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Country | US
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Telephone | 941-748-5885
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Fax | 941-749-5664
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Provider Business Mailing Address
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Address Line | 802 40TH ST W
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City | BRADENTON
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State | FL
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Zip | 34205-1724
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Country | US
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Telephone | 941-748-5885
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Fax | 941-749-5664
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME46189
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | ME46189
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License Number State | FL
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