| Doctor Name: | DR. JORGE MENDEZ -LOPEZ |
| NPI Number: | 1205833274 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 14861 |
| Business Practice Address: | 41 Calle Piscis Urb. Los Angeles Carolina, PR - 009791620 |
| Business Phone Number: | 7877915712 |
| Business Fax Number: | 7872533689 |
| Mailing Address: | 1640 Calle Tamesis, El Paraiso SAN JUAN |
| State: | PR |
| Postal Code: | 009262953 |
| Phone Number: | 7874023757 |
| Fax Number: | 7872926953 |
| NPI Enumeration Date: | 07/05/2005 |
| NPI Last Update Date: | 11/25/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 14861 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |