Doctor Name: | JULIO ENRIQUE MENENDEZ DEJESUS |
NPI Number: | 1528139029 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 3512 |
Business Practice Address: | 159 East Ramos Antonini Street Mayaguez, PR - 00680 |
Business Phone Number: | 7878340073 |
Business Fax Number: | 7878312676 |
Mailing Address: | 103 Palencia Street, Urbanizacion Sultana MAYAGUEZ |
State: | PR |
Postal Code: | 006801148 |
Phone Number: | 7872654501 |
Fax Number: | |
NPI Enumeration Date: | 11/13/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 3512 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |