Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 9856 | PR |
NPI | 1104915909 |
---|---|
Provider Name | Mr. Rafael L Mendez-Rodriguez |
First Address | Aguadilla, PR 00605-3814 |
Second Address | Yauco, PR 00698-3814 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 13/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G41278 | (02) |