Provider Demographics
NPI:1851317580
Name:VENDRELL, MARGARITA MERCEDES (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGARITA
Middle Name:MERCEDES
Last Name:VENDRELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12276 SAN JOSE BLVD STE 608
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-8672
Mailing Address - Country:US
Mailing Address - Phone:904-446-9205
Mailing Address - Fax:904-446-9250
Practice Address - Street 1:12276 SAN JOSE BLVD
Practice Address - Street 2:STE. 608
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-8628
Practice Address - Country:US
Practice Address - Phone:904-446-9205
Practice Address - Fax:904-446-9250
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME71818207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL255038500Medicaid
FL32762YMedicare ID - Type Unspecified
FLG43390Medicare UPIN