Provider Demographics
NPI:1508074576
Name:MENDEZ, NILINES (RPH)
Entity Type:Individual
Prefix:
First Name:NILINES
Middle Name:
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:NILINES
Other - Middle Name:
Other - Last Name:MENDEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5157
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-5157
Mailing Address - Country:US
Mailing Address - Phone:787-640-0715
Mailing Address - Fax:
Practice Address - Street 1:CARR 446 KM2.7 ROBLES
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685
Practice Address - Country:US
Practice Address - Phone:787-640-0715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4999183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist