Mariela Carla Mendieta, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

3775 N Lecanto Hwy
Beverly Hills, FL 34465-3559

Phone

(352) 746-0600

NPI assigned

Mar 17, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1647475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1225786239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12110 RED QUILL LN APT 1218",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328173572",
            "telephone_number": "786-422-3026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3775 N LECANTO HWY",
            "city": "BEVERLY HILLS",
            "state": "FL",
            "postal_code": "344653559",
            "telephone_number": "352-746-0600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12110 Red Quill Ln Apt 1218",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328173572",
            "country_code": "US",
            "telephone_number": "786-422-3026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDIETA",
        "first_name": "MARIELA",
        "middle_name": "CARLA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-17",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Beverly Hills, FL
• Providers in Beverly Hills, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; 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.