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General NPI Number Information
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NPI Number | 1639845233
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Entity Type | Individual
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Provider Name | KATHLEEN MENDEZ SHARP RBT
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Gender | Female
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Dates
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Enumeration Date | 08/23/2021
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 6941 SW 196TH AVE STE B29
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City | FORT LAUDERDALE
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State | FL
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Zip | 33332-1611
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Country | US
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Telephone | 954-999-5597
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Fax | 786-597-0516
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Provider Business Mailing Address
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Address Line | 1339 W 49TH PL APT 306A
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City | HIALEAH
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State | FL
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Zip | 33012-8125
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Country | US
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Telephone | 305-965-0751
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Fax |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-21-174305
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA20165
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License Number State | FL
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