Individual
FERNANDO F MENDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
224-D CORNWALL STREET, NW, SUITE 202, LEESBURG, VA 20176-2700
(703) 443-8110
(703) 443-2714
Mailing address
224 D CORNWALL STREET NW, STE 403, LEESBURG, VA 20176-2704
(703) 737-6010
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110840623
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891789426
—
VA
05
—
30016109960001
—
VA
Enumeration date
09/09/2005
Last updated
04/10/2024
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