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NPI Code Detail

MEDICARE: MS. EVANGELINA MENDIOLA ARNP

MEDICARE: MS. EVANGELINA MENDIOLA ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse Practitioner2504712FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306950845
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. EVANGELINA MENDIOLA ARNP
Provider Business Mailing Address
First Line : 900 S PINE ISLAND RD
Second Line : SUITE 800
City : PLANTATION
State : FL
Zip : 33324-3920
Country : US
Telephone Number : 954-486-8020
Fax Number : 954-486-8983
Provider Business Practice Location Address
First Line : 4400 N STATE ROAD 7
Second Line :
City : LAUDERDALE LAKES
State : FL
Zip : 33319-5862
Country : US
Telephone Number : 954-486-8020
Fax Number : 954-486-8983
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2006
Last Update Date : 10/08/2014

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