MEDICARE: DR. PAUL D. MENDOZA 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	207RR0500X	Rheumatology Physician	ME 115428	FL

General Provider Information

NPI Number	:	1659577831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL D. MENDOZA M.D.

Provider Business Mailing Address
First Line	:	6056 BOYNTON BEACH BLVD STE 145
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-3500
Country	:	US
Telephone Number	:	561-626-9696
Fax Number	:	561-439-4874

Provider Business Practice Location Address
First Line	:	7108 FAIRWAY DR STE 300
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418
Country	:	US
Telephone Number	:	561-626-9696
Fax Number	:	561-626-2264

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

Provider Enumeration Date	:	06/25/2007
Last Update Date	:	01/31/2019

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