Provider Demographics
NPI:1376254367
Name:HERNANDEZ MENDEZ, TATYANA A (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TATYANA
Middle Name:A
Last Name:HERNANDEZ MENDEZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:C1 CALLE PARKSIDE 4, SAN PATRICIO
Mailing Address - Street 2:AVE PUEBLO VIEJO
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:C1 CALLE PARKSIDE 4, SAN PATRICIO
Practice Address - Street 2:AVE PUEBLO VIEJO
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968
Practice Address - Country:US
Practice Address - Phone:787-792-0780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-09
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7078183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist