Provider Demographics
NPI:1275599953
Name:MENDOZA, CESAR EMILIO (MD)
Entity Type:Individual
Prefix:
First Name:CESAR
Middle Name:EMILIO
Last Name:MENDOZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 NW 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1101
Mailing Address - Country:US
Mailing Address - Phone:786-466-8456
Mailing Address - Fax:305-573-6562
Practice Address - Street 1:1801 NW 9TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1101
Practice Address - Country:US
Practice Address - Phone:786-466-8456
Practice Address - Fax:305-573-6562
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88251207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ090480Medicaid
FL0054760-00Medicaid
FLGD175ZOtherMEDICARE