Provider Demographics
NPI:1912909102
Name:MENDEZ RIVERA, ZENAIDA (MD)
Entity Type:Individual
Prefix:MS
First Name:ZENAIDA
Middle Name:
Last Name:MENDEZ RIVERA
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 9003
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-8038
Mailing Address - Country:US
Mailing Address - Phone:787-740-2120
Mailing Address - Fax:787-995-6887
Practice Address - Street 1:BAYAMON MEDICAL PLZ
Practice Address - Street 2:STE 201
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-7200
Practice Address - Country:US
Practice Address - Phone:787-740-2120
Practice Address - Fax:787-995-6887
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6970208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0028443Medicare ID - Type UnspecifiedSURGEON
PRD08456Medicare UPIN