Individual
JACKELINE ANN MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16534 NW 89TH PL, MIAMI LAKES, FL 33018-6172
(786) 382-5274
Mailing address
16534 NW 89TH PL, MIAMI LAKES, FL 33018-6172
(786) 382-5274
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6348
FL
Other
Enumeration date
01/02/2024
Last updated
01/02/2024
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