Provider Demographics
NPI:1417934332
Name:MENDEZ MOLINA, CARMEN A (MD)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:A
Last Name:MENDEZ MOLINA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:TURQUESA #30
Mailing Address - Street 2:SENDEROS EN MONTEHIEDRA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7064
Mailing Address - Country:US
Mailing Address - Phone:787-636-8272
Mailing Address - Fax:
Practice Address - Street 1:AVE. PONCE DE LEON PARADA 37 1/2
Practice Address - Street 2:SUITE 608 TORRE AUXILIO MUTUO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-7064
Practice Address - Country:US
Practice Address - Phone:787-777-8181
Practice Address - Fax:787-777-8180
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR12903207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR21542Medicare PIN
PRH89947Medicare UPIN