DAMODARA RAO MENDU PHD NPI 1396115630

NPI Information

NPI: 1396115630
Provider Name: DAMODARA RAO MENDU, PHD
Classification: Pathology - 247ZC0005X
Entity Type: Individual

Specialization: Clinical Laboratory Director, Non-physician

Address:
6555 NW 9TH AVE
SUITE 209
FT LAUDERDALE, FL
ZIP 33309
Phone: (954) 925-6533
Get Directions

Damodara Rao Mendu, PHD is a clinical laboratory director and non-physician pathology in Ft Lauderdale, FL. The provider is an individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments of 1988 for non-physicians (non-MD/DO) as defined in the CFR 42 Part 493.1405. Damodara Rao Mendu, PHD NPI is 1396115630. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6555 NW 9TH AVE
SUITE 209
FT LAUDERDALE, FL
ZIP 33309-067
Phone: (954) 925-6533

The enumeration date for this NPI number is 9/29/2015 and was last updated on 9/29/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	247ZC0005X	Pathology	Clinical Laboratory Director, Non-physician	DI46724	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	DI46724	OTHER	FLORIDA	FLORIDA LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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