Individual
DR. WILLIAM MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 MAR WALT DR, FORT WALTON BEACH, FL 32547-6708
(850) 863-7607
(205) 437-5998
Mailing address
2725 EDGEWATER DR, NICEVILLE, FL 32578-2310
(850) 897-9106
(850) 650-8820
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME83187
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03176
BCBS
FL
01
—
059184923
BCBS PROVIDER NUMBER
AL
01
—
059184924
BCBS PROVIDER NUMBER
AL
05
—
262309900
—
FL
Enumeration date
05/03/2006
Last updated
05/07/2009
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