MEDICARE: DR. RIGOBERTO JOSEPH 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	2082S0105X	Surgery of the Hand (Plastic Surgery) Physician	036-099790	IL

General Provider Information

NPI Number	:	1912065871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RIGOBERTO JOSEPH MENDOZA M.D.

Provider Business Mailing Address
First Line	:	4710 N HABANA AVE STE 202
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-7146
Country	:	US
Telephone Number	:	813-803-9111
Fax Number	:	630-305-0289

Provider Business Practice Location Address
First Line	:	4710 N HABANA AVE STE 202
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-7146
Country	:	US
Telephone Number	:	813-803-9111
Fax Number	:	630-305-0289

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

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	01/12/2023

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