Provider Demographics
NPI:1841263449
Name:MENENDEZ, SANDRA (MD)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:
Last Name:MENENDEZ
Suffix:
Gender:F
Credentials:MD
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 884
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-0884
Mailing Address - Country:US
Mailing Address - Phone:787-877-8181
Mailing Address - Fax:787-877-8181
Practice Address - Street 1:59 CALLE PEDRO SANTOS
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676-4010
Practice Address - Country:US
Practice Address - Phone:787-877-8181
Practice Address - Fax:787-877-8181
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-13
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7241174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist