MEDICARE: MS. LAURA HERNANDEZ MENDEZ MD

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	103K00000X	Behavior Analyst
2	106S00000X	Behavior Technician	RBT-19-98360	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	:	1679112601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAURA HERNANDEZ MENDEZ MD

Provider Business Mailing Address
First Line	:	1495 FOREST HILL BLVD STE A1
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-6073
Country	:	US
Telephone Number	:	786-560-8559
Fax Number	:

Provider Business Practice Location Address
First Line	:	312 SOUTH DIXIE HIGHWAY
Second Line	:	SUITE 202
City	:	JUPITER
State	:	FL
Zip	:	33458
Country	:	US
Telephone Number	:	786-560-8559
Fax Number	:

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

Provider Enumeration Date	:	12/20/2019
Last Update Date	:	03/24/2026

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