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Individual

JOSE E MENDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
12600 PEMBROKE RD STE 310, MIRAMAR, FL 33027-2544
(954) 431-7681
(954) 431-7682
Mailing address
12600 PEMBROKE RD STE 310, MIRAMAR, FL 33027-2544
(954) 431-7681
(954) 431-7682

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
2014-00246
NC
207N00000X
Dermatology Physician
Primary
OS7092
FL
207Q00000X
Family Medicine Physician
OS0007092
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
251021901
FL
Enumeration date
08/16/2005
Last updated
11/23/2020
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