Individual ProviderLuis Junior Diaz MendezNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address12820 SW 146th Ter, Miami, FL 33186-6358(786) 378-1171PECOS EnrollmentBased on the most recent information from CMS, provider Luis Junior Diaz Mendez does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1932931706Provider TypeIndividualFull NameDiaz Mendez, Luis JuniorGenderMaleSole ProprietorNoEnumeration Date8/19/2024Last Updated1/20/2025Contact InformationPractice LocationPractice Address12820 SW 146th Ter, Miami, FL 33186-6358Phone(786) 378-1171FaxUnlisted FaxMailing LocationMailing Address12820 SW 146th Ter, Miami, FL 33186-6358Phone(786) 378-1171FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode367500000XPrimaryDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicense1179618Texas