NPIMap

Organization Active NPI

John V Mendola M D

  • Health Service Clinic/Center
  • Lehigh Acres, FL
National Provider Identifier
1174951198
Registry record updated Oct 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
ME 117536 Issued in FL
Legal business name
JOHN V MENDOLA M D
Practice address
10 Beth Stacey Blvd
Unit 104
Lehigh Acres, FL 33936-6047
Phone
(201) 709-3586
NPI assigned
Oct 30, 2013
Last updated
Oct 30, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. John Vincent Mendola, MD
Title
MD
Phone
(201) 709-3586

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X ME 117536 FL Primary

Addresses

Primary practice location

10 Beth Stacey Blvd
Unit 104
Lehigh Acres, FL 33936-6047

Mailing address

10 Beth Stacey Blvd
Unit 104
Lehigh Acres, FL 33936
Phone (201) 709-3586

Other names 1

  • john v mendola md llc Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Agape Behavioral Center72 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 7

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383091200000",
    "number": "1174951198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 BETH STACEY BLVD",
            "address_2": "UNIT 104",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "33936",
            "telephone_number": "201-709-3586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 BETH STACEY BLVD",
            "address_2": "UNIT 104",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339366047",
            "telephone_number": "201-709-3586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN V MENDOLA M D",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-30",
        "last_updated": "2013-10-30",
        "status": "A",
        "authorized_official_last_name": "MENDOLA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "VINCENT",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "201-709-3586",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "FL",
            "license": "ME 117536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "john v mendola md llc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Lehigh Acres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.