Individual provider Active NPI

Gemma Jacqueline Mendieta, ED.S

  • School Psychologist
  • Miami, FL
National Provider Identifier
1467696567
Registry record updated Apr 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
SS791 Issued in FL
Practice address
5888 SW 27TH St
Miami, FL 33155-3135
Phone
(305) 662-4236
NPI assigned
Apr 21, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X SS791 FL Primary

Addresses

Primary practice location

5888 SW 27TH St
Miami, FL 33155-3135

Mailing address

5888 SW 27TH St
Miami, FL 33155-3135
Phone (305) 662-4236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SS791FLMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1240272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240272000000",
    "number": "1467696567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5888 SW 27TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331553135",
            "telephone_number": "305-662-4236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5888 SW 27TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331553135",
            "telephone_number": "305-662-4236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDIETA",
        "first_name": "GEMMA",
        "middle_name": "JACQUELINE",
        "credential": "ED.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-21",
        "last_updated": "2009-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "FL",
            "license": "SS791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.