Provider Demographics
NPI:1679020440
Name:MENDEZ-RODRIGUEZ, SONYA AILED (PHT)
Entity Type:Individual
Prefix:MRS
First Name:SONYA
Middle Name:AILED
Last Name:MENDEZ-RODRIGUEZ
Suffix:
Gender:F
Credentials:PHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARR 119 KM 35.2
Mailing Address - Street 2:BO PIEDRAS BLANCA
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685
Mailing Address - Country:US
Mailing Address - Phone:787-896-1665
Mailing Address - Fax:787-896-1690
Practice Address - Street 1:CARR 119 KM 35.2
Practice Address - Street 2:BO PIEDRAS BLANCA
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685
Practice Address - Country:US
Practice Address - Phone:787-896-1665
Practice Address - Fax:787-896-1690
Is Sole Proprietor?:No
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8572183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician