Provider Demographics
NPI:1033490024
Name:MENDEZ-PEREZ, MARIA ELDA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:ELDA
Last Name:MENDEZ-PEREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11715 SW 18TH ST
Mailing Address - Street 2:# 307
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-1623
Mailing Address - Country:US
Mailing Address - Phone:305-882-5664
Mailing Address - Fax:
Practice Address - Street 1:11715 SW 18TH ST
Practice Address - Street 2:# 307
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-1623
Practice Address - Country:US
Practice Address - Phone:305-882-5664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-02
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00244932084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL057271300Medicaid
D79935Medicare UPIN
FL057271300Medicaid