Individual
OLGA L. MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1470 NW 107TH AVE STE M, SWEETWATER, FL 33172-2735
(786) 238-7282
(833) 927-2568
Mailing address
1470 NW 107TH AVE STE M, SWEETWATER, FL 33172-2735
(786) 238-7282
(833) 927-2568
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
14862
PR
208D00000X
General Practice Physician
Primary
ACN1116
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500454E
MMM
—
Enumeration date
11/28/2006
Last updated
01/10/2022
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