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General NPI Number Information
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NPI Number | 1811872989
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Entity Type | Individual
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Provider Name | YANIA CAROLINA MENDOZA BRISTOL
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Gender | Female
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Dates
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Enumeration Date | 08/07/2025
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 3600 MANSELL RD FL 4
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City | ALPHARETTA
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State | GA
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Zip | 30022-3079
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Country | US
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Telephone | 787-568-8937
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Fax |
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Provider Business Mailing Address
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Address Line | 1414 WINTERS PARK DR APT 1414
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City | DORAVILLE
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State | GA
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Zip | 30360-3214
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Country | US
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Telephone | 787-568-8937
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH035734
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License Number State | GA
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