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General NPI Number Information
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NPI Number | 1912195017
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Entity Type | Individual
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Provider Name | JOSE YSRAEL MENDEZ MD
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Gender | Male
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Dates
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Enumeration Date | 10/15/2007
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Last Update Date | 07/01/2020
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Provider Practice Location Address
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Address Line | 8615 COMMODITY CIR SUITE 12
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City | ORLANDO
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State | FL
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Zip | 32819-9071
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Country | US
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Telephone | 407-476-1212
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Fax | 407-476-1213
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Provider Business Mailing Address
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Address Line | 8615 COMMODITY CIR SUITE 12
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City | ORLANDO
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State | FL
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Zip | 32819-9071
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Country | US
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Telephone | 407-476-1212
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Fax | 407-476-1213
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME107982
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME107982
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | ME107982
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME107982
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License Number State | FL
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