Provider Demographics
NPI:1639388952
Name:MENDEZ, OLGA I (MD)
Entity Type:Individual
Prefix:DR
First Name:OLGA
Middle Name:I
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:OLGA
Other - Middle Name:I
Other - Last Name:MENDEZ-MENDEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1900 CALLE SAN LUIS
Mailing Address - Street 2:URB. HORIZONS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-5309
Mailing Address - Country:US
Mailing Address - Phone:787-765-4727
Mailing Address - Fax:787-765-4727
Practice Address - Street 1:1900 CALLE SAN LUIS
Practice Address - Street 2:URB. HORIZONS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-5309
Practice Address - Country:US
Practice Address - Phone:787-765-4727
Practice Address - Fax:787-765-4727
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3236208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics