Individual
MICHAEL JESSE MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
409 BAYSHORE BLVD, TAMPA, FL 33606-2707
(813) 844-7137
(813) 844-4142
Mailing address
PO BOX 1289, TAMPA, FL 33601-1289
(813) 844-7712
(813) 844-4142
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY7603
FL
103TC0700X
Clinical Psychologist
PY7603
FL
Other
Enumeration date
10/21/2008
Last updated
02/03/2025
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