Healthcare Provider Details

I. General information

NPI: 1831011188
Provider Name (Legal Business Name): CHINICOL MARIE MENDEZ CORDERO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BO VOLADORAS CARR 420 KM 2.0 INT
MOCA PR
00676
US

IV. Provider business mailing address

PO BOX 2131
MOCA PR
00676-2131
US

V. Phone/Fax

Practice location:
  • Phone: 939-414-4644
  • Fax:
Mailing address:
  • Phone: 939-414-4644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number9101
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: