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NPI Code Detail

MEDICARE: YESENIA MENDOZA

MEDICARE: YESENIA MENDOZA
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
1103K00000XBehavior Analyst1-24-78408FL
2106S00000XBehavior Technician

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 : 1568105724
Entity Type Code : Individual
Provider Name (Legal Business Name) : YESENIA MENDOZA
Provider Business Mailing Address
First Line : 20940 NW 1ST ST
Second Line :
City : PEMBROKE PINES
State : FL
Zip : 33029-2121
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5959 LAKE ELLENOR DR
Second Line :
City : ORLANDO
State : FL
Zip : 32809-4633
Country : US
Telephone Number : 407-574-4928
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2022
Last Update Date : 02/05/2026

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Directions to “ YESENIA MENDOZA ” Practice Location

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