Jose Mendez MD PA

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

ME107982 Issued in FL

Legal business name

JOSE MENDEZ MD PA

Practice address

8615 Commodity Cir Ste 12
Orlando, FL 32819

Phone

(407) 476-1212

Fax

(407) 476-1213

NPI assigned

Nov 6, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Jose Y Mendez, MDNPI 1912195017

Title

President

Phone

(407) 738-3030

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

House of Freedom2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• House of Freedom

  • Psychiatry Physician
  • Kissimmee, FL
  • NPI 1245582543
  NPD tax ID

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jose Ysrael Mendez, MD

  • Psychiatry Physician
  • Orlando, FL
  • NPI 1912195017

  Family Medicine

  Medicare reassignment NPD Authorized official
• Jose Antonio Vera, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Sanford, FL
  • NPI 1669702270
  Medicare reassignment NPD
• Yuliet Castillo, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Orlando, FL
  • NPI 1811515141
  NPD (past)

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

{
    "created_epoch": "1352160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596067200000",
    "number": "1407100951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8615 COMMODITY CIR STE 12",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328199072",
            "telephone_number": "407-476-1212",
            "fax_number": "407-476-1213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8615 COMMODITY CIR STE 12",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32819",
            "telephone_number": "407-476-1212",
            "fax_number": "407-476-1213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2311 N Orange Blossom Trl",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347442313",
            "country_code": "US",
            "telephone_number": "407-957-9077",
            "fax_number": "888-702-0079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JOSE MENDEZ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-06",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A",
        "authorized_official_last_name": "MENDEZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-738-3030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "FL",
            "license": "ME107982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005210100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "14M9E",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zoila Elizabeth Jorro, D.O
• Jose a Ortiz DMD PL
• Jose Andrade MD PA
• Jose Andrade MD PA
• Jose I Cardenas MD PA
• Jalina Jose
• Kristina Marie Jose, M.D.
• Reeni Jose, PMHNP
• Sheena Mary Jose, MD
• Sruthy Jose

• Adult Mental Health Clinic/Center in Orlando, FL
• Providers in Orlando, FL by specialty
• Adult Mental Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.