Individual
ILEY MAE MENDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, MSN
Contact information
Practice address
11100 DOMAIN DR, JACKSONVILLE, FL 32256-4133
(405) 694-0911
Mailing address
11100 DOMAIN DR APT 135, JACKSONVILLE, FL 32256-4138
(405) 694-0911
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
11036584
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
1096845
TX
363LA2200X
Adult Health Nurse Practitioner
11036584
FL
Other
Enumeration date
10/27/2022
Last updated
03/07/2026
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