Kellie Mosley Mendez DO, PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

OS7914 Issued in FL

Legal business name

KELLIE MOSLEY MENDEZ DO, PA

Practice address

15600 NW 67TH Ave
Suite 105
Miami Lakes, FL 33014-2174

Phone

(305) 557-0414

Fax

(305) 557-0496

NPI assigned

Sep 28, 2009

Last updated

Sep 28, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kellie Ann Mosley Mendez, D.O.

Title

Owner/President

Phone

(305) 557-0414

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1254096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254096000000",
    "number": "1316271182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15600 NW 67TH AVE",
            "address_2": "SUITE 105",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142174",
            "telephone_number": "305-557-0414",
            "fax_number": "305-557-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15600 NW 67TH AVE",
            "address_2": "SUITE 105",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142174",
            "telephone_number": "305-557-0414",
            "fax_number": "305-557-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLIE MOSLEY MENDEZ DO, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-28",
        "last_updated": "2009-09-28",
        "status": "A",
        "authorized_official_last_name": "MOSLEY MENDEZ",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "305-557-0414",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "OS7914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Miami Lakes, FL
• Providers in Miami Lakes, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2009; 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.