Provider Demographics
NPI:1629959705
Name:MENDELOW, DOVID
Entity type:Individual
Prefix:
First Name:DOVID
Middle Name:
Last Name:MENDELOW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19790 W DIXIE HWY STE 1208
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2548
Mailing Address - Country:US
Mailing Address - Phone:786-220-1539
Mailing Address - Fax:
Practice Address - Street 1:19790 W DIXIE HWY STE 1208
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2548
Practice Address - Country:US
Practice Address - Phone:786-220-1539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty