1114149663 NPI number — JANIT MENDEZ-HERNANDEZ

Table of content: JANIT MENDEZ-HERNANDEZ (NPI 1114149663)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114149663 NPI number — JANIT MENDEZ-HERNANDEZ

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MENDEZ-HERNANDEZ
Provider First Name:
JANIT
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114149663
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
HC 01 BOX 4856
Provider Second Line Business Mailing Address:
BO. CIBAO
Provider Business Mailing Address City Name:
CAMUY
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00627-9610
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-449-2369
Provider Business Mailing Address Fax Number:
787-262-4822

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BO CIBAO
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMUY
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00627-9610
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-449-2369
Provider Business Practice Location Address Fax Number:
787-262-4822
Provider Enumeration Date:
05/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183700000X , with the licence number:  3282 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3282 . This is a "TECNICO FARMACIA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com