WANDA MENDEZ


Address: 4558 Hermosa Rd, Crestview, FL 32539-6731
Phone: 6092848410

WANDA MENDEZ (NPI# 1306103254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1306103254
Entity Type Individual
Full Name WANDA MENDEZ
Credential IDMT
Practice Address 4558 Hermosa Rd
Crestview
FL 32539-6731
Mailing Address 307 Boatner Rd
Eglin Afb
FL 32542-1302
Practice Telephone 6092848410
Mailing Telephone 8508838663
Enumeration Date 2012-04-17
Last Update Date 2014-11-12
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1710I1003X Military Health Care Provider
Specialization: Independent Duty Medical Technicians
Other Service Providers

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Office Location

Street Address 4558 HERMOSA RD
City CRESTVIEW
State FL
Zip Code 32539-6731

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1326418336 Abc Pediatrics of Okaloosa Pediatrics 182 E. Redstone Ave, Suite B, Crestview, FL 32539 2015-10-02
1336498443 Jessica Carolina Carroll Counselor 259 E. Oakdale Ave, Crestview, FL 32539 2012-09-05
1902167166 Patricia Guess Registered Nurse 6011 Aubrey Lee Ln, Crestview, FL 32539 2012-06-05
1699048181 Chien Nguyen Clinical Medical Laboratory 151 East Redstone Avenue, Crestview, FL 32539 2012-02-15
1043494164 Crestview Mri Clinic/Center 700 Hospital Drive, Crestview, FL 32539 2007-12-26
1558581215 Barnes Healthcare of Fl LLC Durable Medical Equipment & Medical Supplies 450 Brookmeade Dr, Crestview, FL 32539 2007-04-26
1568576098 Okaloosa Youth Development Center Substance Abuse Rehabilitation Facility 4449 Straighline Road, Crestview, FL 32539 2006-08-19
1154368181 Marcello Borzatta Surgery 129 E. Redstone Ave, Suite A, Crestview, FL 32539 2006-05-31
1902850258 Panhandle Orthopaedics LLC Physical Therapist 710 Hospital Drive, Crestview, FL 32539 2006-05-20
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Taxonomy Information

Taxonomy Code 1710I1003X
Grouping Other Service Providers
Classification Military Health Care Provider
Specialization Independent Duty Medical Technicians

Taxonomy Definition

An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians.
Notes: Source: Air Force Surgeon General Office [7/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1821439712 Eric John Muelhausen Military Health Care Provider 6151 Evergreen Pkwy, Crestview, FL 32539-7702 2013-07-09
1164861704 Jared Steven Sleeman Military Health Care Provider 524 Tikell Dr, Crestview, FL 32536-5427 2013-06-17

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1457994394 Nathaniel Clay Hollandsworth Military Health Care Provider 517 Harrison Dr, Hurlburt Field, FL 32544-1100 2019-10-23
1316592355 Tiffany Nicole Monroe Military Health Care Provider 6280 Ferguson Dr, Pensacola, FL 32503-7769 2019-08-06
1881197069 David Joseph Bergstrom Military Health Care Provider 2293 Frontera St, Navarre, FL 32566-6202 2018-03-14
1144723321 Paris Johnae Milton Military Health Care Provider 340 Magnolia Cir # 5612, Tyndall Afb, FL 32403-5604 2018-03-14
1538681226 Qynne M Shoemaker Military Health Care Provider 1008 E Strawbridge Ave, Melbourne, FL 32901-4909 2017-07-13
1891196531 Lorex Boy Lagora Military Health Care Provider 1010 Nw 91st St, Miami, FL 33150-2352 2014-09-12
1366865321 Stephanie Fike Military Health Care Provider 2804 Winners Circle Dr, Navarre, FL 32566-8820 2014-01-28
1639506579 Aaron Newby Military Health Care Provider 3434 Skysail Pl, Tampa, FL 33607-5828 2013-10-10
1457790875 Caige Carter Chapman Military Health Care Provider 1935 Jo Tam Lane, Navarre, FL 32566 2013-06-19
1467707638 Jennifer Denise Mathis Military Health Care Provider 913 Claeven Cir, Fort Walton Beach, FL 32547-4257 2012-07-13
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Competitor

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City CRESTVIEW
Zip Code 32539

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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