Provider Demographics
NPI:1407149305
Name:MENDEZ, CHRISTIAN (BCBA)
Entity Type:Individual
Prefix:MS
First Name:CHRISTIAN
Middle Name:
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 NW 25TH ST APT 417
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33127-4347
Mailing Address - Country:US
Mailing Address - Phone:786-457-5665
Mailing Address - Fax:
Practice Address - Street 1:2222 PONCE DE LEON BLVD STE 6-107
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5039
Practice Address - Country:US
Practice Address - Phone:786-310-2352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-25
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst