Doctor Name: | DR. GARY MENDELOW |
NPI Number: | 1902825839 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | ME58449 |
Business Practice Address: | 22221 Morning Glory Ter Boca Raton, FL - 334334811 |
Business Phone Number: | 5613912818 |
Business Fax Number: | 5613910554 |
Mailing Address: | 22221 Morning Glory Ter, BOCA RATON |
State: | FL |
Postal Code: | 334334811 |
Phone Number: | 5613912818 |
Fax Number: | 5613910554 |
NPI Enumeration Date: | 07/19/2006 |
NPI Last Update Date: | 08/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ME58449 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |