| Doctor Name: | ANTONIO B MENCHAVEZ |
| NPI Number: | 1043328263 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CRNA |
| License Number: | ARNP 1349432 |
| Business Practice Address: | 1800 Se Tiffany Ave Port St Lucie, FL - 349527521 |
| Business Phone Number: | 7723352471 |
| Business Fax Number: | 7723352497 |
| Mailing Address: | Po Box 7520, PORT ST LUCIE |
| State: | FL |
| Postal Code: | 349857520 |
| Phone Number: | 7723352471 |
| Fax Number: | 7723352497 |
| NPI Enumeration Date: | 08/28/2006 |
| NPI Last Update Date: | 07/31/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WM0705X |
| License Number: | ARNP 1349432 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Medical-Surgical |
| Taxonomy Definition: | |