MEDICARE: VANESSA GURRI MENDEZ

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	363LF0000X	Family Nurse Practitioner	11038793	FL

General Provider Information

NPI Number	:	1710771274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA GURRI MENDEZ

Provider Business Mailing Address
First Line	:	2901 BLEDSOE ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-2903
Country	:	US
Telephone Number	:	786-569-0544
Fax Number	:	786-569-0544

Provider Business Practice Location Address
First Line	:	2901 BLEDSOE ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-2903
Country	:	US
Telephone Number	:	786-569-0544
Fax Number	:	786-569-0544

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

Provider Enumeration Date	:	04/08/2025
Last Update Date	:	06/02/2026

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