Individual
QUERUBIN POLOCARPIO MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5101 N HABANA AVE, TAMPA, FL 33614-6818
(813) 248-2700
(813) 248-2722
Mailing address
5101 N HABANA AVE, TAMPA, FL 33614-6818
(813) 248-2700
(813) 248-2722
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME0074240
FL
207UN0901X
Nuclear Cardiology Physician
ME74240
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0118255
GHI
FL
01
—
1018644
CAREPLUS
FL
01
—
1210679
AETNA
FL
01
—
14363001
CITRUS HEALTH
FL
01
—
176468283681
HUMANA
FL
01
—
2250675
CIGNA
FL
01
—
22661
AVMED
FL
01
—
2504898
UNITED HEALTHCARE
FL
05
—
254936100
—
FL
01
—
42448
BLUE CROSS BLUE SHIELD
FL
01
—
DE6354
RR MEDICARE
FL
Enumeration date
09/20/2005
Last updated
03/22/2016
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