Active NPI
Mendoza Behavioral Health LLC
- Psychiatry Physician
- Daytona Beach, FL
National Provider Identifier
1295262137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- ACN216
- Legal business name
- MENDOZA BEHAVIORAL HEALTH LLC
- Practice address
- 110 Orange Ave
Daytona Beach, FL 32114-4310 - Phone
- (386) 256-4326
- NPI assigned
- May 22, 2017
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Liana Mendoza, MD
- Title
- Psychiatrist
- Phone
- (386) 254-2637
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
National Provider Directory
National Provider DirectoryLocations
110 Orange Ave
Daytona Beach, FL 32114
Phone (386) 256-4326
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | ACN216 | FL | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
110 Orange Ave
Daytona Beach, FL 32114-4310
Mailing address
110 Orange Ave
Daytona Beach, FL 32114-4310
Other identifiers 1
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 280152300 | Medicaid | FL |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 11, 2019.
{
"created_epoch": "1495411200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1560211200000",
"number": "1295262137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 ORANGE AVE",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321144310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 ORANGE AVE",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321144310",
"telephone_number": "386-256-4326"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MENDOZA BEHAVIORAL HEALTH LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-05-22",
"last_updated": "2019-06-11",
"status": "A",
"authorized_official_last_name": "MENDOZA",
"authorized_official_first_name": "LIANA",
"authorized_official_title_or_position": "PSYCHIATRIST",
"authorized_official_telephone_number": "386-254-2637",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "ACN216",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "280152300",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Daytona Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.