Provider Demographics
NPI:1316141443
Name:MENDEZ, LORELY ESTHER (MD)
Entity type:Individual
Prefix:DR
First Name:LORELY
Middle Name:ESTHER
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3805 W 20TH AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4532
Mailing Address - Country:US
Mailing Address - Phone:305-557-2277
Mailing Address - Fax:305-557-2278
Practice Address - Street 1:18380 NW 7TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-4410
Practice Address - Country:US
Practice Address - Phone:305-654-9009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME103361208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice