Provider Demographics
NPI:1811770068
Name:MENDEZ, YARELIS
Entity type:Individual
Prefix:
First Name:YARELIS
Middle Name:
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1142
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-1142
Mailing Address - Country:US
Mailing Address - Phone:787-621-3700
Mailing Address - Fax:
Practice Address - Street 1:CALLE HERNANDEZ CARRION CARR #2
Practice Address - Street 2:INTERSECCION 668, URBANIZACION ATENAS
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-1142
Practice Address - Country:US
Practice Address - Phone:787-621-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16814208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice