Organization Name: | DR JOSE M MENDEZJIMINIAN CSP |
NPI Number: | 1093052433 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSE M MENDEZ JIMINIAN (PRESIDENT) |
Mailing Address: | 353 Ave General Valero Fajardo |
State: | PR US |
Postal Code: | 007384843 |
Phone Number: | 7878634714 |
Fax Number: | 7876552301 |
NPI Enumeration Date: | 01/04/2013 |
NPI Last Update Date: | 01/04/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QC1800X |
License Number: | 12631 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Corporate Health |
Taxonomy Definition: |