Provider Demographics
NPI:1417753146
Name:MENDING HEALTHCARE LLC
Entity type:Organization
Organization Name:MENDING HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YORDANYS
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDES
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:505-307-5837
Mailing Address - Street 1:6539 W HANNA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-4961
Mailing Address - Country:US
Mailing Address - Phone:505-307-5837
Mailing Address - Fax:
Practice Address - Street 1:6539 W HANNA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-4961
Practice Address - Country:US
Practice Address - Phone:505-307-5837
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty