Provider Demographics
NPI:1558913152
Name:MENDEZ, IVETTE (DC)
Entity Type:Individual
Prefix:DR
First Name:IVETTE
Middle Name:
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 ISLAND BLVD APT 304
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2406
Mailing Address - Country:US
Mailing Address - Phone:630-656-7829
Mailing Address - Fax:
Practice Address - Street 1:1250 E HALLANDALE BEACH BLVD STE 305
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4644
Practice Address - Country:US
Practice Address - Phone:754-231-8338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-12
Last Update Date:2019-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12869111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor