Individual provider Active NPI

Deborah Mendoza, PA

  • Physician Assistant
  • Weston, FL
National Provider Identifier
1467562843
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA3658 Issued in FL
Practice address
2300 N Commerce Pkwy Ste 303
Weston, FL 33326-3256
Phone
(954) 349-0460
Fax
(954) 217-3222
NPI assigned
Aug 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA3658 FL Primary

Addresses

Primary practice location

2300 N Commerce Pkwy Ste 303
Weston, FL 33326-3256

Mailing address

2600 Lake Lucien Dr Ste 180
Maitland, FL 32751-7235
Phone (407) 875-2080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081121000459 FL Practitioner - Physician Assistant 4688734551 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1410 W Broadway St
Suite 205
Oviedo, FL 32765-6472
Phone (407) 359-2100

1495 Kingsley Ave
Orange Park, FL 32073-4501
Phone (904) 354-4488

1503 Buenos Aires Blvd
Suite 100
The Villages, FL 32159-6825
Phone (352) 753-2812

1639 Atlantic Blvd
Suite 100
Jacksonville, FL 32207-3346
Phone (904) 354-4488

200 Southpark Blvd
Suite 209
St Augustine, FL 32086-3129
Phone (904) 354-4488

3 Pine Cone Dr
Suite 102
Palm Coast, FL 32137-8684
Phone (386) 864-6005

71 Doctors Village Dr
Suite 304
Saint Johns, FL 32259-2406
Phone (904) 547-2580

8 Office Park Dr
Palm Coast, FL 32137-3808
Phone (386) 446-4466

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Leavitt Medical Associates of Florida Inc CurrentSince Nov 1, 2008 Accepting new patients
Leavitt Medical Associates of Florida Inc Past Accepting new patients

Locations

1905 Clint Moore Rd
Ste 103
Boca Raton, FL 33496
Phone (561) 241-4474

82245 Overseas Hwy
Islamorada, FL 33036
Phone (305) 664-0700

12525 Philips Hwy
Ste 101
Jacksonville, FL 32256
Phone (904) 400-6565

151 Southhall Ln
Ste 300
Maitland, FL 32751
Phone (407) 917-7293

1410 W Broadway St
Ste 205
Oviedo, FL 32765
Phone (407) 359-2100

1503 Buenos Aires Blvd
Ste 100
The Villages, FL 32159
Phone (352) 753-2812

2300 N Commerce Pkwy
Ste 303
Weston, FL 33326
Phone (954) 217-3171

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467562843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 LAKE LUCIEN DR STE 180",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517235",
            "telephone_number": "407-875-2080",
            "fax_number": "407-875-0518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N COMMERCE PKWY STE 303",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333263256",
            "telephone_number": "954-349-0460",
            "fax_number": "954-217-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "DEBORAH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA3658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, FL

Sources for this page

Verify at the official NPI Registry.