Provider Demographics
NPI:1912065871
Name:MENDOZA, RIGOBERTO JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:RIGOBERTO
Middle Name:JOSEPH
Last Name:MENDOZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4710 N HABANA AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-7146
Mailing Address - Country:US
Mailing Address - Phone:813-803-9111
Mailing Address - Fax:630-305-0289
Practice Address - Street 1:4710 N HABANA AVE STE 202
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-7146
Practice Address - Country:US
Practice Address - Phone:813-803-9111
Practice Address - Fax:630-305-0289
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-0997902082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILG97069Medicare UPIN