Provider Demographics
NPI:1417543281
Name:MENDEZ, ANDREA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:MENDEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARM D
Mailing Address - Street 1:15395 NW 82ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-6478
Mailing Address - Country:US
Mailing Address - Phone:305-364-1143
Mailing Address - Fax:
Practice Address - Street 1:15395 NW 82ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-6478
Practice Address - Country:US
Practice Address - Phone:305-364-1143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS45890183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist