MEDICARE: DR. LORELY ESTHER MENDEZ M.D.

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
1	208D00000X	General Practice Physician	ME103361	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1316141443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LORELY ESTHER MENDEZ M.D.

Provider Business Mailing Address
First Line	:	3805 W 20TH AVE
Second Line	:	SUITE 105
City	:	HIALEAH
State	:	FL
Zip	:	33012-4532
Country	:	US
Telephone Number	:	305-557-2277
Fax Number	:	305-557-2278

Provider Business Practice Location Address
First Line	:	18380 NW 7TH AVE
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-4410
Country	:	US
Telephone Number	:	305-654-9009
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2007
Last Update Date	:	12/06/2021

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