Provider Demographics
NPI:1336690783
Name:MENENDEZ-BRUNO, VICTOR SR (HEALTH EDUCATOR)
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:
Last Name:MENENDEZ-BRUNO
Suffix:SR
Gender:M
Credentials:HEALTH EDUCATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 VEREDA LOS LAURELES
Mailing Address - Street 2:COND CAMINOS DEL BOSQUE
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:350 AVE CHARDON
Practice Address - Street 2:500 TORRE CHARDON
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2124
Practice Address - Country:US
Practice Address - Phone:787-622-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator