Michelle Lora Mendez
Developmental Therapist in Lake Wales, FL. Individual provider (NPI-1).
NPI number1114439866
StatusActive
Last updated in NPPESJul 29, 2021
Details
- NPI
- 1114439866
- Entity type
- Individual (NPI-1)
- Name
- Michelle Lora Mendez
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Nov 2, 2017
- Certification date
- Jul 29, 2021
- Last updated
- Jul 29, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 222Q00000X | Developmental Therapist | – | FL | Yes |
Practice location
4360 Dinner Lake BlvdLake Wales, FL 33859-2129
Phone 863-232-7615
Mailing address
4360 Dinner Lake BlvdLake Wales, FL 33859-2129
Phone 863-232-7615
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Other Developmental Therapist providers in Lake Wales, FL
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