Organization
MENDOZA BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIANA MENDOZA MD (PSYCHIATRIST)
(386) 254-2637
Entity
Organization
Contact information
Practice address
110 ORANGE AVE, DAYTONA BEACH, FL 32114-4310
(386) 256-4326
Mailing address
110 ORANGE AVE, DAYTONA BEACH, FL 32114-4310
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ACN216
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
280152300
—
FL
Enumeration date
05/22/2017
Last updated
06/11/2019
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