Healthcare Provider Details

I. General information

NPI: 1093804924
Provider Name (Legal Business Name): RENIER J MENDEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: RENIER MENDEZ DE GUZMAN M.D.

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

E22 CALLE SANTA CRUZ URB. SANTA CRUZ
BAYAMON PR
00961-6905
US

IV. Provider business mailing address

4B CALLE MEADOW LN URB. GEORGETOWN
GUAYNABO PR
00966-2602
US

V. Phone/Fax

Practice location:
  • Phone: 787-740-4286
  • Fax: 787-787-9082
Mailing address:
  • Phone: 787-740-4286
  • Fax: 787-787-9082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number5790
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: