Individual
AMADO JOSE MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
1395 N COURTENAY PKWY, 102, MERRITT ISLAND, FL 32953-4400
(321) 986-8812
Mailing address
1395 N COURTENAY PKWY, 102, MERRITT ISLAND, FL 32953-4400
(321) 986-8812
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
892101600
—
FL
01
—
PT 9938
LICENSE #
FL
Enumeration date
08/30/2006
Last updated
01/29/2020
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