Individual
MARIELENA MENDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSA
Contact information
Practice address
1012 S 12TH ST, LANTANA, FL 33462-4432
(561) 436-8157
Mailing address
23111 SW 54TH AVE, BOCA RATON, FL 33433-7933
(954) 461-4851
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
3692
FL
Other
Enumeration date
09/20/2011
Last updated
09/20/2011
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