MEDICARE: MENDEZIZED NANO HEALING PRODUCTS, INC

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	175F00000X	Naturopath

General Provider Information

NPI Number	:	1396167037
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MENDEZIZED NANO HEALING PRODUCTS, INC

Provider Business Mailing Address
First Line	:	15401 NE 21ST AVE
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-6007
Country	:	US
Telephone Number	:	305-885-2619
Fax Number	:	305-885-1326

Provider Business Practice Location Address
First Line	:	15401 NE 21ST AVE
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-6007
Country	:	US
Telephone Number	:	305-885-2619
Fax Number	:	305-885-1326

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALEJANDRO MENDEZ
Credential	:
Telephone Number	:	305-885-2619

Provider Enumeration Date	:	01/15/2014
Last Update Date	:	03/06/2014

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