Provider Demographics
NPI:1447446539
Name:RICHARD C MENDEL MD FACS PA
Entity type:Organization
Organization Name:RICHARD C MENDEL MD FACS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:MENDEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-627-7855
Mailing Address - Street 1:3370 BURNS RD STE 200
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4327
Mailing Address - Country:US
Mailing Address - Phone:561-627-7855
Mailing Address - Fax:561-627-5030
Practice Address - Street 1:3370 BURNS RD STE 200
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4327
Practice Address - Country:US
Practice Address - Phone:561-627-7855
Practice Address - Fax:561-627-5030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98035207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty