Provider Demographics
NPI:1679204507
Name:MENDEZ, BEATRIZ ISABEL
Entity Type:Individual
Prefix:
First Name:BEATRIZ
Middle Name:ISABEL
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 SW 109TH AVE UNIT 1020
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-1372
Mailing Address - Country:US
Mailing Address - Phone:787-948-2599
Mailing Address - Fax:
Practice Address - Street 1:740 SW 109TH AVE UNIT 1020
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-1372
Practice Address - Country:US
Practice Address - Phone:787-948-2599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty