Provider Demographics
NPI:1457475881
Name:MENDOZA, ADALBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:ADALBERTO
Middle Name:
Last Name:MENDOZA
Suffix:
Gender:M
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:PO BOX 10729
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732
Mailing Address - Country:US
Mailing Address - Phone:787-841-0042
Mailing Address - Fax:787-848-4043
Practice Address - Street 1:234 PONCE
Practice Address - Street 2:PARQUE INDUSTRIAL SABANETAS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00715
Practice Address - Country:US
Practice Address - Phone:787-841-8640
Practice Address - Fax:787-843-3464
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4871207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology