Provider Demographics
NPI:1316688385
Name:MENDEZ, MARCOS JAVIER (PHARM D)
Entity type:Individual
Prefix:DR
First Name:MARCOS
Middle Name:JAVIER
Last Name:MENDEZ
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8711 NW 19TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-3304
Mailing Address - Country:US
Mailing Address - Phone:305-934-1823
Mailing Address - Fax:
Practice Address - Street 1:8711 NW 19TH ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-3304
Practice Address - Country:US
Practice Address - Phone:305-934-1823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS47206183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist