Provider Demographics
NPI:1104458223
Name:MENDEZ, SAID AZAEL
Entity type:Individual
Prefix:MR
First Name:SAID
Middle Name:AZAEL
Last Name:MENDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2853 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-1960
Mailing Address - Country:US
Mailing Address - Phone:402-615-3542
Mailing Address - Fax:
Practice Address - Street 1:5000 SAINT PAUL AVE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-2760
Practice Address - Country:US
Practice Address - Phone:402-465-7508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer