NPIMap

Organization Active NPI

Brenilda Mendoza

  • Occupational Therapy Assistant
  • Kissimmee, FL
National Provider Identifier
1417309196
Registry record updated Jul 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA13972 Issued in FL
Legal business name
BRENILDA MENDOZA
Practice address
628 Gazelle Dr
Kissimmee, FL 34759-4208
Phone
(407) 747-4288
NPI assigned
Jul 6, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2016

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

Authorized official

Name
Brenilda Luz Mendoza, COTA
Title
License
Phone
(407) 747-4288

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 224Z00000X OTA13972 FL Primary

Addresses

Primary practice location

628 Gazelle Dr
Kissimmee, FL 34759-4208

Mailing address

628 Gazelle Dr
Kissimmee, FL 34759-4208
Phone (407) 747-4288

Other names 1

  • Brenilda Mendoza Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1467763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467763200000",
    "number": "1417309196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 GAZELLE DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347594208",
            "telephone_number": "407-747-4288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 GAZELLE DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347594208",
            "telephone_number": "407-747-4288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENILDA MENDOZA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-06",
        "last_updated": "2016-07-06",
        "status": "A",
        "authorized_official_last_name": "MENDOZA",
        "authorized_official_first_name": "BRENILDA",
        "authorized_official_middle_name": "LUZ",
        "authorized_official_title_or_position": "LICENSE",
        "authorized_official_telephone_number": "407-747-4288",
        "authorized_official_credential": "COTA"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA13972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brenilda Mendoza",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2016; 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.