Mendiola, Evangelina

Mendiola, Evangelina is an individual health care provider with primary practice located at 4400 N State Road 7 , Lauderdale Lakes FL 33319-5862. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Mendiola, Evangelina can be contacted via phone (954) 486-8020.

Contact Information

Primary practice address
4400 N State Road 7 Lauderdale Lakes FL 33319-5862
Phone: (954) 486-8020
Fax: (954) 486-8983
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 2504712 Florida

Profile Details

NPI number 1306950845
LBN Legal business name Mendiola, Evangelina
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2006
Last updated Oct 8th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306950845 NPPES
Florida MEDICAID 304835700

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