| Mendez Family Care Pa | |
|
1909 Beach Blvd Ste 102 Jacksonville Beach FL 32250-2643 | |
| (904) 246-2752 | |
| (904) 246-2758 |
| Full Name | Mendez Family Care Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1909 Beach Blvd Ste 102, Jacksonville Beach, Florida |
| Authorized Official Name and Position | Zanda M Chandler (CFO) |
| Authorized Official Contact | 9045891112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mendez Family Care Pa 1909 Beach Blvd Ste 102 Jacksonville FL 32250-2643 Ph: (904) 246-2752 | Mendez Family Care Pa 1909 Beach Blvd Ste 102 Jacksonville Beach FL 32250-2643 Ph: (904) 246-2752 |
| NPI Number | 1205854171 |
|---|---|
| Provider Enumeration Date | 07/18/2006 |
| Last Update Date | 06/09/2023 |
| Medicare PECOS PAC ID | 0840200606 |
|---|---|
| Medicare Enrollment ID | O20060425000387 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205854171 | NPI | - | NPPES |
| DF4853 | Other | FL | MEDICARE RAILROAD |
| 277539500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Michelle R Mendez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740202456 PECOS PAC ID: 8527969286 Enrollment ID: I20040115000858 |
| Provider Name | Robin Tighe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013661214 PECOS PAC ID: 0446630586 Enrollment ID: I20220706003237 |
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