Provider Demographics
NPI:1447568522
Name:EUGENIO MENENDEZ D.O., P.A.
Entity Type:Organization
Organization Name:EUGENIO MENENDEZ D.O., P.A.
Other - Org Name:POMPANO BEACH INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENIO
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:MENENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:305-968-3912
Mailing Address - Street 1:6278 N FEDERAL HWY
Mailing Address - Street 2:SUITE 331
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-1916
Mailing Address - Country:US
Mailing Address - Phone:305-968-3912
Mailing Address - Fax:
Practice Address - Street 1:1600 E ATLANTIC BLVD
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060-6768
Practice Address - Country:US
Practice Address - Phone:954-942-2247
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-22
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9361207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI32239Medicare UPIN