Provider Demographics
NPI:1467485094
Name:MENDOLIA, NADIA (PT)
Entity Type:Individual
Prefix:
First Name:NADIA
Middle Name:
Last Name:MENDOLIA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 35TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-4829
Mailing Address - Country:US
Mailing Address - Phone:561-842-8193
Mailing Address - Fax:561-842-8193
Practice Address - Street 1:431 35TH ST
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-4829
Practice Address - Country:US
Practice Address - Phone:561-842-8193
Practice Address - Fax:561-842-8193
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT10462225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist