Individual provider Active NPI

Breanna Kathleen Mendoza, APRN

  • Nurse Practitioner
  • Sebring, FL
National Provider Identifier
1740011303
Registry record updated Oct 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11034730 Issued in FL
Practice address
4958 Sun N Lake Blvd Ste B
Sebring, FL 33872-2159
Phone
(863) 386-4711
NPI assigned
Aug 13, 2024
Last updated
Oct 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11034730 FL Primary

Addresses

Primary practice location

4958 Sun N Lake Blvd Ste B
Sebring, FL 33872-2159

Mailing address

500 Reba Dr
Lake Placid, FL 33852-6827
Phone (863) 633-8606

Other practice location 1

511 W Interlake Blvd
Lake Placid, FL 33852-0703
Phone (863) 386-4711

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
I20240912004583 FL Practitioner - Nurse Practitioner 9931649217 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Joint and Spine Institute PAGroup PAC ID 0547168114, 13 clinicians

Practice addresses (Care Compare)

5115 US Hwy 27 N
Suite 100
Sebring, FL 33870-1323
Phone (863) 385-2222

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Joint & Spine Institute PA CurrentSince Aug 26, 2024 Accepting new patients
Florida Joint & Spine Institute PA CurrentSince Aug 26, 2024 Accepting new patients

Locations

5115 US 27 N
Ste 100
Sebring, FL 33870
Phone (863) 385-2222

146 Avenue B NW
Winter Haven, FL 33881
Phone (863) 229-3210

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: breanna.mendoza@floridajointandspine.directbygreenway.com
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71998

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1723507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791936000000",
    "number": "1740011303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 REBA DR",
            "city": "LAKE PLACID",
            "state": "FL",
            "postal_code": "338526827",
            "telephone_number": "863-633-8606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4958 SUN N LAKE BLVD STE B",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338722159",
            "telephone_number": "863-386-4711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "511 W Interlake Blvd",
            "address_purpose": "LOCATION",
            "city": "Lake Placid",
            "state": "FL",
            "postal_code": "338520703",
            "country_code": "US",
            "telephone_number": "863-386-4711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "BREANNA",
        "middle_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-13",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11034730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebring, FL

Sources for this page

Verify at the official NPI Registry.