WANDA MENDEZ (NPI# 1306103254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| 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 |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1003X |
Military Health Care Provider Specialization: Independent Duty Medical Technicians |
Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144721986 | Wanda Ivette Mendez | Specialist/Technologist | 19102 Walbrook Meadows Ln, Cypress, TX 77433-2762 | 2018-02-27 |
| 1376798439 | Wanda C Mendez | Occupational Therapist | 9728 3rd Avenue, Brooklyn, NY 11209-7203 | 2008-11-17 |
| 1851576649 | Wanda I Mendez | Pharmacist | Centro Medico Hospital Industrial, Pharmacy Department, San Juan, PR 00926 | 2007-12-31 |
| Street Address |
4558 HERMOSA RD |
| City | CRESTVIEW |
| State | FL |
| Zip Code | 32539-6731 |
| 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 |
| 1619941440 | Yale R Smith | Anesthesiology | 151 Redstone Ave Se, Pinnacle Physicians LLC, Crestview, FL 32539 | 2006-02-16 |
| Find all providers in zip 32539 | ||||
| Taxonomy Code | 1710I1003X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Medical Technicians |
| 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] |
| 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 |
| 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 |
| Find all providers with the same taxonomy | ||||
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| 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.