Provider Demographics
NPI:1891278875
Name:APONTE MENDOZA, LUIS O (PA)
Entity Type:Individual
Prefix:MR
First Name:LUIS
Middle Name:O
Last Name:APONTE MENDOZA
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:704 DOCTORS CT.
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748
Mailing Address - Country:US
Mailing Address - Phone:352-728-3252
Mailing Address - Fax:352-728-0558
Practice Address - Street 1:704 DOCTORS CT.
Practice Address - Street 2:SUITE 101
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748
Practice Address - Country:US
Practice Address - Phone:352-728-3252
Practice Address - Fax:352-728-0558
Is Sole Proprietor?:No
Enumeration Date:2018-09-14
Last Update Date:2018-09-14
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant