Provider Demographics
NPI:1407048994
Name:OSCAR MENDEZ MD PA
Entity Type:Organization
Organization Name:OSCAR MENDEZ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDENZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-717-4066
Mailing Address - Street 1:5950 W OAKLAND PARK BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33313-1260
Mailing Address - Country:US
Mailing Address - Phone:954-717-4066
Mailing Address - Fax:954-717-4069
Practice Address - Street 1:5950 W OAKLAND PARK BLVD STE 300
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313-1260
Practice Address - Country:US
Practice Address - Phone:954-717-4066
Practice Address - Fax:954-717-4069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1574777OtherCOVENTRY HEALTH
20107OtherEVOLUTIONS HEALTH CARE
FL279292300Medicaid
103099OtherFREEDOM HEALTH
FL279292300Medicaid