Provider Demographics
NPI:1114149663
Name:MENDEZ-HERNANDEZ, JANIT
Entity Type:Individual
Prefix:
First Name:JANIT
Middle Name:
Last Name:MENDEZ-HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 01 BOX 4856
Mailing Address - Street 2:BO. CIBAO
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-9610
Mailing Address - Country:US
Mailing Address - Phone:787-449-2369
Mailing Address - Fax:787-262-4822
Practice Address - Street 1:BO CIBAO
Practice Address - Street 2:
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627-9610
Practice Address - Country:US
Practice Address - Phone:787-449-2369
Practice Address - Fax:787-262-4822
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3282183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3282OtherTECNICO FARMACIA