Provider Demographics
NPI:1477907681
Name:MENDEZ, EDUARDO (SA-C)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:
Last Name:MENDEZ
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1815 W 56TH ST APT 104
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7325
Mailing Address - Country:US
Mailing Address - Phone:786-503-1908
Mailing Address - Fax:
Practice Address - Street 1:1815 W 56TH ST APT 104
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-7325
Practice Address - Country:US
Practice Address - Phone:786-503-1908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-14
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant