Provider Demographics
NPI:1902030885
Name:MENDEZ, LOURDES S (RPT)
Entity Type:Individual
Prefix:
First Name:LOURDES
Middle Name:S
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LA VILLA GDNS APTS
Mailing Address - Street 2:APARTAMENTO 202-D CARR. 833 NUMERO 26
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00971-9001
Mailing Address - Country:US
Mailing Address - Phone:787-319-6278
Mailing Address - Fax:787-785-6975
Practice Address - Street 1:CALLE 2 J16 EDIF MEDICO HNAS DAVILA
Practice Address - Street 2:SUITE 110
Practice Address - City:BAYAMON
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00959-5045
Practice Address - Country:UM
Practice Address - Phone:787-787-3838
Practice Address - Fax:787-785-6975
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-07
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR785225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist