Provider Demographics
NPI:1467231415
Name:MENDEZ CORTES, TOMAS J
Entity Type:Individual
Prefix:
First Name:TOMAS
Middle Name:J
Last Name:MENDEZ CORTES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 59 BOX 5924
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-9649
Mailing Address - Country:US
Mailing Address - Phone:787-390-1405
Mailing Address - Fax:
Practice Address - Street 1:CARR. #5 KM. 6.1 INDUSTRIAL LUCCHETTI
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00960
Practice Address - Country:US
Practice Address - Phone:787-786-4370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6833103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling