Individual
LOURDES M MENDEZ MIURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 N CENTRAL AVE STE 110, KISSIMMEE, FL 34741-4439
(407) 530-5063
(877) 399-5578
Mailing address
4096 LAKE BOSSE VIEW DR, ORLANDO, FL 32810-1905
(407) 970-4294
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
12/24/2024
Last updated
12/24/2024
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