Provider Demographics
NPI:1093804924
Name:MENDEZ, RENIER J (MD)
Entity Type:Individual
Prefix:DR
First Name:RENIER
Middle Name:J
Last Name:MENDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RENIER
Other - Middle Name:
Other - Last Name:MENDEZ DE GUZMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4B CALLE MEADOW LN
Mailing Address - Street 2:URB. GEORGETOWN
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-2602
Mailing Address - Country:US
Mailing Address - Phone:787-740-4286
Mailing Address - Fax:787-787-9082
Practice Address - Street 1:E22 CALLE SANTA CRUZ
Practice Address - Street 2:URB. SANTA CRUZ
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6905
Practice Address - Country:US
Practice Address - Phone:787-740-4286
Practice Address - Fax:787-787-9082
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5790208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR97300Medicare ID - Type Unspecified