Healthcare Provider Details

I. General information

NPI: 1346166337
Provider Name (Legal Business Name): AIDA DEL C MENDOZA RODRIGUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PARKING VISTA VERDE CALLE ZAFIRO
MAYAGUEZ PR
00680
US

IV. Provider business mailing address

29 CALLE SOL
SAN GERMAN PR
00683-3945
US

V. Phone/Fax

Practice location:
  • Phone: 787-597-7061
  • Fax:
Mailing address:
  • Phone: 787-248-8292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number3478
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number3478
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: