Provider Demographics
NPI:1023258373
Name:HERNANDEZ MENDEZ, MARIO FRANCISCO (MD)
Entity type:Individual
Prefix:DR
First Name:MARIO
Middle Name:FRANCISCO
Last Name:HERNANDEZ MENDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3001 W DR MLK BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6307
Mailing Address - Country:US
Mailing Address - Phone:813-870-4933
Mailing Address - Fax:813-870-4887
Practice Address - Street 1:3001 W DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:MS - 3075
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6307
Practice Address - Country:US
Practice Address - Phone:813-870-4933
Practice Address - Fax:813-870-4887
Is Sole Proprietor?:No
Enumeration Date:2009-02-26
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME110150207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003650000Medicaid
FL5819755OtherCIGNA HEALTHCARE
FLP00945325OtherRAILROAD MEDICARE
FL1085628OtherCAREPLUS
FL14E8COtherBCBS OF FLORIDA
FL3199303OtherUNITED HEALTHCARE
FL9009570OtherAETNA US HEALTHCARE
FLFB542ZMedicare PIN