Individual
DR. ANSELMO M MENDIVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4601 NW 199TH ST, SUITE E, MIAMI GARDENS, FL 33055-1508
(305) 801-7030
(305) 274-4032
Mailing address
4601 NW 199TH ST, SUITE E, MIAMI GARDENS, FL 33055-1508
(305) 801-7030
(305) 274-4032
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME56412
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
048992100
—
FL
05
—
048992101
—
FL
Enumeration date
03/19/2008
Last updated
03/24/2008
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