Provider Demographics
NPI:1205102118
Name:MENDEZ CASTANER, LUMEN ALBERTO (MD)
Entity type:Individual
Prefix:
First Name:LUMEN
Middle Name:ALBERTO
Last Name:MENDEZ CASTANER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 W SR 434 STE 1164
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-5008
Mailing Address - Country:US
Mailing Address - Phone:407-894-4693
Mailing Address - Fax:
Practice Address - Street 1:2501 N ORANGE AVE STE 537N
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4674
Practice Address - Country:US
Practice Address - Phone:407-894-4693
Practice Address - Fax:407-896-0569
Is Sole Proprietor?:No
Enumeration Date:2012-03-25
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME124246207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015142700Medicaid
FLIG076ZMedicare PIN