Provider Demographics
NPI:1962099598
Name:MENDOZA, YOSLEIDY (PHARMACY THENICIAN)
Entity type:Individual
Prefix:MS
First Name:YOSLEIDY
Middle Name:
Last Name:MENDOZA
Suffix:
Gender:F
Credentials:PHARMACY THENICIAN
Other - Prefix:MISS
Other - First Name:YOSLEIDY
Other - Middle Name:
Other - Last Name:MENDOZA
Other - Suffix:SR
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:13896 SW 56TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6021
Mailing Address - Country:US
Mailing Address - Phone:305-387-2415
Mailing Address - Fax:
Practice Address - Street 1:13896 SW 56TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6021
Practice Address - Country:US
Practice Address - Phone:305-387-2415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
141253374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician