Provider Demographics
NPI:1922606268
Name:MENDEZ BLANCART, MERCEDES
Entity Type:Individual
Prefix:
First Name:MERCEDES
Middle Name:
Last Name:MENDEZ BLANCART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MERCEDES
Other - Middle Name:
Other - Last Name:SARDINA MENDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4786 NW 3RD ST APT 3
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-5264
Mailing Address - Country:US
Mailing Address - Phone:561-481-3266
Mailing Address - Fax:
Practice Address - Street 1:4786 NW 3RD ST APT 3
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-5264
Practice Address - Country:US
Practice Address - Phone:561-481-3266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-09
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician