Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 18237 | PR |
NPI | 1205086410 |
---|---|
Provider Name | Javier A Mendez Ruiz |
First Address | Mayaguez, PR 00680-1509 |
Second Address | Mayaguez, PR 00680-1509 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2008 |
Last Update Date | 24/08/2015 |