Provider Demographics
NPI:1437458262
Name:CENTRO DE REUMATOLOGIA DR MENDEZ BRYAN INC
Entity Type:Organization
Organization Name:CENTRO DE REUMATOLOGIA DR MENDEZ BRYAN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:F
Authorized Official - Last Name:GARCIA JAUNARENA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-763-1876
Mailing Address - Street 1:575 CALLE CABO H ALVERIO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-3725
Mailing Address - Country:US
Mailing Address - Phone:787-763-1876
Mailing Address - Fax:787-250-1918
Practice Address - Street 1:575 CALLE CABO H ALVERIO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3725
Practice Address - Country:US
Practice Address - Phone:787-763-1876
Practice Address - Fax:787-250-1918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-18
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11014207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0083384Medicare PIN