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General NPI Number Information
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NPI Number | 1659923480
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Entity Type | Individual
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Provider Name | DR. YOANIS MENDOZA
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Gender | Male
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Dates
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Enumeration Date | 07/11/2019
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Last Update Date | 07/11/2019
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Provider Practice Location Address
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Address Line | 6285 MINTON RD NE
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City | PALM BAY
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State | FL
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Zip | 32907-3008
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Country | US
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Telephone | 321-306-0300
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Fax |
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Provider Business Mailing Address
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Address Line | 104 VERACRUZ AVE
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City | KISSIMMEE
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State | FL
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Zip | 34743-7035
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Country | US
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Telephone | 407-232-3062
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 12837
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License Number State | FL
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