Provider Demographics
NPI:1710196688
Name:MENDEZ, MANUEL ARTURO (RPH)
Entity Type:Individual
Prefix:MR
First Name:MANUEL
Middle Name:ARTURO
Last Name:MENDEZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:I7 CALLE EBANO APT 203
Mailing Address - Street 2:CONDOMINIO MADRESELVA
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968-3103
Mailing Address - Country:US
Mailing Address - Phone:787-706-1933
Mailing Address - Fax:
Practice Address - Street 1:CALLE SANTA CRUZ #70
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00960
Practice Address - Country:US
Practice Address - Phone:787-740-4747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3725183500000X
FLPS 27234183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist