Jose Antonio Mendieta, APRN

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

APRN11031146 Issued in FL

Practice address

1512 N 15TH Ter
Hollywood, FL 33020-3247

Phone

(630) 292-0949

NPI assigned

Feb 12, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• Cape Coral Hospitalists Inc

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1336209790
  Medicare reassignment NPD
• Cogent Healthcare of Pensacola LLC

  • Internal Medicine Physician
  • Jacksonville Beach, FL
  • NPI 1346287182
  Medicare reassignment NPD
• Cogent Healthcare of Pensacola LLC

  • Internal Medicine Physician
  • Lehigh Acres, FL
  • NPI 1336722446
  NPD
• Cogent Healthcare of Pensacola LLC

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1427631696
  NPD

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1881458784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 N 15TH TER",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330203247",
            "telephone_number": "630-292-0949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 N 15TH TER",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330203247",
            "telephone_number": "630-292-0949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDIETA",
        "first_name": "JOSE",
        "middle_name": "ANTONIO",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-12",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11031146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle S Mendelsohn, OCCUPATIONAL THERAPI
• Mikayla Corinne Mendenhall, BSN
• Bella Gleiser Mendez, APRN
• Mikaela Mendez, PA-C
• Erick Manuel Mendieta, ARNP
• Juan Carlos Mendoza Iglesias, D.M.D.
• Kattys Elena Mendoza
• Laura Mendoza
• Aldo Menendez Arcia, PHYSICIAN ASSISTANT
• Lidaimis Lazara Menendez Prieto

• Gerontology Nurse Practitioner in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Gerontology Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.