Provider Demographics
NPI:1194100073
Name:MENDEZ, JESSICA (ARNP)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11191 GRANDVIEW MNR
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-8840
Mailing Address - Country:US
Mailing Address - Phone:352-226-6298
Mailing Address - Fax:
Practice Address - Street 1:12788 FOREST HILL BLVD STE 1004
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-4703
Practice Address - Country:US
Practice Address - Phone:561-331-5155
Practice Address - Fax:561-907-6019
Is Sole Proprietor?:No
Enumeration Date:2015-07-21
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9235381363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily