Provider Demographics
NPI:1265491088
Name:MENDELSOHN, HILLARY (CRNA)
Entity Type:Individual
Prefix:
First Name:HILLARY
Middle Name:
Last Name:MENDELSOHN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:C/O ANESCO ANESTHESIA ASSOCIATES INC
Mailing Address - Street 2:4631 NW 31ST AVENUE #127
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309
Mailing Address - Country:US
Mailing Address - Phone:954-485-5666
Mailing Address - Fax:954-484-1651
Practice Address - Street 1:C/O NORTH RIDGE MEDICAL CENTER
Practice Address - Street 2:5757 NORTH DIXIE HIGHWAY
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33334
Practice Address - Country:US
Practice Address - Phone:954-776-6000
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1633562367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG0312AMedicare ID - Type Unspecified