MEDICARE: ALIELKIS MENDEZ APRN

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	APRN11029312	FL

General Provider Information

NPI Number	:	1801669882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALIELKIS MENDEZ APRN

Provider Business Mailing Address
First Line	:	3746 RACCOON RD
Second Line	:
City	:	ZOLFO SPRINGS
State	:	FL
Zip	:	33890-6712
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3746 RACCOON RD
Second Line	:
City	:	ZOLFO SPRINGS
State	:	FL
Zip	:	33890-6712
Country	:	US
Telephone Number	:	305-510-9076
Fax Number	:	863-774-1645

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

Provider Enumeration Date	:	11/01/2023
Last Update Date	:	11/09/2025

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